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Screening colonoscopy interval

Marco Bustamante-Balén, Carla Satorres, Lorena Puchades, Belén Navarro, Natalia García-Morales, Noelia Alonso, Marta Ponce, Lidia Argüello, Vicente Pons-Beltrán
BACKGROUND: The implementation of optical diagnosis (OD) of diminutive colorectal lesions in clinical practice has been hampered by differences in performance between community and academic settings. One possible cause is the lack of a standardized learning tool. Since the factors related to better learning are not well described, strong evidence upon which a consistent learning tool could be designed is lacking. We hypothesized that a self-designed learning program may be enough to achieve competency in OD of diminutive lesions of the colon...
March 14, 2019: World Journal of Gastroenterology: WJG
Chris Hurt, Rajeswari Ramaraj, Angela Farr, Meleri Morgan, Namor Williams, Ceri J Philips, Geraint T Williams, Georgina Gardner, Catherine Porter, Julian Sampson, Sharon Hillier, Hayley Heard, Sunil Dolwani
BACKGROUND: Most post-colonoscopy interval colorectal cancers are proximal; serrated polyps are often precursors to these cancers and are considered difficult to detect. We assessed the safety, feasibility, and economic effect of chromocolonoscopy on detection of proximal serrated neoplasia. METHODS: We did an open-label, multicentre, randomised, controlled non-inferiority trial including patients from Bowel Screening Wales centres. Participants who tested positive for faecal occult blood and who were eligible for and considered fit to have colonoscopy (patients with known cases of polyposis syndromes, Lynch syndrome, and chronic inflammatory disease were excluded) were randomly assigned (1:1; with the use of minimisation, stratified by centre with an 80:20 random element) to either standard white light colonoscopy (standard group) or chromocolonoscopy (indigo carmine dye [0·2%]; chromocolonoscopy group) using a secure, internet-based, computerised, randomisation system that used centralised, dynamic allocation...
March 15, 2019: Lancet. Gastroenterology & Hepatology
Anand K Narayan, Diego B Lopez, Avinash R Kambadakone, Debra A Gervais
PURPOSE: Colon cancer screening reduces deaths from colorectal cancer. Screening rates have plateaued; however, studies have found that giving patients a choice between different screening tests improves adherence. CT colonography is a minimally invasive screening test with high sensitivity for colonic polyps (>1 cm). With increasing insurance coverage of CT colonography nationwide, there are limited estimates of CT colonography utilization over time. Our purpose was to estimate CT colonography utilization over time using nationally representative cross-sectional survey data...
March 9, 2019: Journal of the American College of Radiology: JACR
Konstantinos Triantafyllou, Paraskevas Gkolfakis, Georgios Tziatzios, Ioannis S Papanikolaou, Lorenzo Fuccio, Cesare Hassan
BACKGROUND: Endocuff - a plastic device with flexible projections - mounted on the distal tip of the colonoscope, promises improved colonic mucosa inspection. AIM: To elucidate the effect of Endocuff on adenoma detection rate (ADR), advanced ADR (AADR) and mean number of adenomas per colonoscopy (MAC). METHODS: Literature searches identified randomized-controlled trials evaluating Endocuff-assisted colonoscopy (EAC) vs conventional colonoscopy (CC) in terms of ADR, AADR and MAC...
March 7, 2019: World Journal of Gastroenterology: WJG
Radek Kroupa, Monika Ondrackova, Petra Kovalcikova, Milan Dastych, Tomas Pavlik, Lumir Kunovsky, Jiri Dolina
BACKGROUND: Public awareness of colorectal cancer (CRC) and uptake of CRC screening remain challenges. The viewpoints of the target population (asymptomatic individuals older than 50) regarding CRC screening information sources and the reasons for and against participation in CRC screening are not well known in the Czech Republic. This study aimed to acquire independent opinions from the target population independently on the health system. AIM: To investigate the viewpoints of the target population regarding the source of information for and barriers and facilitators of CRC screening...
March 7, 2019: World Journal of Gastroenterology: WJG
Toni T Seppälä, Aysel Ahadova, Mev Dominguez-Valentin, Finlay Macrae, D Gareth Evans, Christina Therkildsen, Julian Sampson, Rodney Scott, John Burn, Gabriela Möslein, Inge Bernstein, Elke Holinski-Feder, Kirsi Pylvänäinen, Laura Renkonen-Sinisalo, Anna Lepistö, Charlotte Kvist Lautrup, Annika Lindblom, John-Paul Plazzer, Ingrid Winship, Douglas Tjandra, Lior H Katz, Stefan Aretz, Robert Hüneburg, Stefanie Holzapfel, Karl Heinimann, Adriana Della Valle, Florencia Neffa, Nathan Gluck, Wouter H de Vos Tot Nederveen Cappel, Hans Vasen, Monika Morak, Verena Steinke-Lange, Christoph Engel, Nils Rahner, Wolff Schmiegel, Deepak Vangala, Huw Thomas, Kate Green, Fiona Lalloo, Emma J Crosbie, James Hill, Gabriel Capella, Marta Pineda, Matilde Navarro, Ignacio Blanco, Sanne Ten Broeke, Maartje Nielsen, Ken Ljungmann, Sigve Nakken, Noralane Lindor, Ian Frayling, Eivind Hovig, Lone Sunde, Matthias Kloor, Jukka-Pekka Mecklin, Mette Kalager, Pål Møller
Background: Recent epidemiological evidence shows that colorectal cancer (CRC) continues to occur in carriers of pathogenic mismatch repair ( path_MMR ) variants despite frequent colonoscopy surveillance in expert centres. This observation conflicts with the paradigm that removal of all visible polyps should prevent the vast majority of CRC in path_MMR carriers, provided the screening interval is sufficiently short and colonoscopic practice is optimal. Methods: To inform the debate, we examined, in the Prospective Lynch Syndrome Database (PLSD), whether the time since last colonoscopy was associated with the pathological stage at which CRC was diagnosed during prospective surveillance...
2019: Hereditary Cancer in Clinical Practice
Robert J Hilsden, Sarah M Rose, Catherine Dube, Alaa Rostom, Ronald Bridges, S Elizabeth McGregor, Darren R Brenner, Steven J Heitman
INTRODUCTION: The adenoma detection rate (ADR) is the best validated colonoscopy performance quality indicator. The ASGE/ACG Task Force on Colonoscopy Quality set an ADR benchmark of ≥25% in a mixed male/female population. We propose a novel means for defining locally relevant ADR benchmarks using data from the population of interest and for applying ADR benchmarks using 95% confidence intervals (CIs) of an endoscopist's ADR. We further propose that ADR benchmarks should be raised to reflect what can be achieved by high-performing endoscopists...
January 29, 2019: American Journal of Gastroenterology
Yanan Wu, Yingru Liang, Qin Zhou, Huazhang Liu, Guozhen Lin, Wenfeng Cai, Yan Li, Jing Gu
BACKGROUND: Colonoscopy adherence among populations at high risk for colorectal cancer (CRC) is crucial for the early diagnosis and treatment of CRC, but the adherence rate has been found to be poor. A short message service (SMS) is effective in promoting cancer screening, but its effectiveness in promoting colonoscopy among populations at high risk for CRC has not been well studied. METHODS: In this randomized controlled trial conducted in Guangzhou, China, participants who had tested positive during preliminary CRC screening (a high-risk factor questionnaire and/or an immunochemical fecal occult blood test) but had not undergone colonoscopy were randomized into low-frequency (monthly) intervention, high-frequency (biweekly) intervention, and control groups...
March 2, 2019: Cancer
Daniel L Christensen, Kyle E Nappo, Jared A Wolfe, Sean M Wade, Daniel I Brooks, Benjamin K Potter, Jonathan A Forsberg, Scott M Tintle
BACKGROUND: Quantifying bone mineral density (BMD) on CT using commercial software demonstrates good-to-excellent correlations with dual-energy x-ray absorptiometry (DEXA) results. However, previous techniques to measure Hounsfield units (HUs) within the proximal femur demonstrate less successful correlation with DEXA results. An effective method of measuring HUs of the proximal femur from CT colonoscopy might allow for opportunistic osteoporosis screening. QUESTIONS/PURPOSES: (1) Do proximal femur HU measurements from CT colonoscopy correlate with proximal femur DEXA results? (2) How effective is our single HU measurement technique in estimating the likelihood of overall low BMD? (3) Does the relationship between our comprehensive HU measurement and DEXA results change based on age, sex, or time between studies? METHODS: This retrospective study investigated the measurement of HU of the femur obtained on CT colonoscopy studies compared with DEXA results...
September 4, 2018: Clinical Orthopaedics and related Research
Yoon Suk Jung, Nam Hee Kim, Mi Yeon Lee, Jung Ho Park, Dong Il Park, Chong Il Sohn
BACKGROUND & AIMS: Previous assessments of colorectal neoplasia (CRN) recurrence after polypectomy used self-report to determine smoking status. We evaluated the association between change in smoking status and metachronous CRN risk after polypectomy using cotinine level in urine to determine tobacco exposure. METHODS: We performed a retrospective study of participants in the Kangbuk Samsung Health Study, in Korea, who underwent a screening colonoscopy examination and measurement of cotinine in urine samples...
February 14, 2019: Clinical Gastroenterology and Hepatology
Nam Hee Kim, Jae Wan Lim, Sunyong Kim, Ji Yeon Lim, Wonsool Kim, Jung Ho Park, Dong Il Park, Chong Il Sohn, Yoon Suk Jung
BACKGROUND: We evaluated the risk of advanced colorectal neoplasia (ACRN) and colorectal cancer (CRC) according to time to colonoscopy after positive fecal immunochemical test (FIT), fecal hemoglobin concentration, and combination of both. METHODS: We analyzed the records of 2362 patients aged ≥50 years who underwent colonoscopy because of a positive FIT result through the National Cancer Screening Program of Korea. RESULTS: ACRN risk increased with increasing time to colonoscopy after a positive FIT (17...
December 23, 2018: Digestive and Liver Disease
Min Cheol Kim, Jung Gil Park, Byung Ik Jang, Heon Ju Lee, Won Kee Lee
Nonalcoholic fatty liver disease (NAFLD) is associated with risks for developing colorectal adenoma. This study aimed to evaluate the association between advanced fibrosis in NAFLD and the risk for colorectal adenoma.We retrospectively analyzed the data of 6332 adults who underwent abdominal ultrasound and 1st-time colonoscopy on the same day in a health screening program at a single center. We evaluated the presence of advanced fibrosis in NAFLD using various noninvasive score, which also analyzed the detection rate of colorectal adenoma according to the presence of advanced fibrosis in NAFLD...
February 2019: Medicine (Baltimore)
Athanasios Mastrokostas, Magda Gavana, Maria Gkrizioti, Emmanouil Smyrnakis, Evangelos Cholongitas, Alexis Benos, Anna-Bettina Haidich
PURPOSE: Our study aimed to compare the views of healthy eligible unscreened adults, to those of primary care providers in Greece, about colorectal cancer (CRC) screening perceived barriers. METHODS: A sample of 791 unscreened adults (50-75 years) from a recent nationwide health survey in Greece were interviewed about CRC screening barriers, and the main reason for not adhering to colonoscopy and fecal occult blood test (FOBT) was assessed. Results were compared to a concurrent survey of 161 primary care professionals (PCPs) from the same region and the agreement with the general population was assessed with odds ratios (OR) and 95% confidence intervals (CI)...
December 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Li-Chun Chang, Chia-Tung Shun, Wen-Feng Hsu, Chia-Hong Tu, Chieh-Chang Chen, Ming-Shiang Wu, Han-Mo Chiu
Background and study aims  Cold snare polypectomy (CSP) is considered to be effective in reducing risk of delayed bleeding but randomized trials fail to support this owing to the small sample size. The current study aimed to compare risk of delayed bleeding before and after implementation of CSP in a screening colonoscopy setting. Patients and methods  This study retrospectively analyzed a prospectively maintained screening colonoscopy database in a university hospital in Taiwan. We compared the rate of delayed bleeding before and after implementation within similar periods (18 months and 15 months) and the respective number of polypectomies (1,304 and 1,255) performed to remove small and diminutive polyps...
February 2019: Endoscopy International Open
V Paul Doria-Rose, Aruna Kamineni, Michael J Barrett, Cynthia W Ko, Noel S Weiss
Case-control studies evaluating a screening test's efficacy in reducing cancer mortality require accurate classification of test indication to obtain a valid result. However, for analogous studies of cancer incidence, determination of test indication is not as critical because, to define exposure, we need consider only tests that can identify precursor lesions whose treatment might prevent cancer, not tests leading to cancer diagnosis. This study utilizes US Surveillance, Epidemiology, and End Results (SEER)-Medicare data, which do not include information about colonoscopy indication, to evaluate the efficacy of colonoscopy in preventing colorectal cancer (CRC) incidence...
January 29, 2019: American Journal of Epidemiology
Nam Hee Kim, Yoon Suk Jung, Jae Wan Lim, Jung Ho Park, Dong Il Park, Chong Il Sohn
BACKGROUND AND AIMS: A fecal immunochemical test (FIT) is often repeated annually, even after a recent colonoscopy. However, there are no published data on the proper approach to FIT-positive patients after a recent colonoscopy. We compared colorectal cancer (CRC) and advanced colorectal neoplasia (ACRN) prevalence based on the interval since the last colonoscopy. METHODS: We reviewed asymptomatic screenees aged ≥50 years who underwent FIT and colonoscopy. RESULTS: Of 2,228 FIT-positive participants, the number who had a colonoscopy less than 3 years prior (Group 1), 3 to 10 years prior (Group 2), and >10 years prior or no colonoscopy (Group 3) was 514, 427, and 1,287, respectively...
January 23, 2019: Gastrointestinal Endoscopy
Erin L Symonds, Stephen R Cole, Su Yin Lau, Simon Steele, Rosie Meng, Richard J Woodman, Graeme P Young, Charles Cock, Robert Fraser, Peter Bampton
BACKGROUND: The international guidelines for surveillance following the finding of a small tubular adenoma vary between no surveillance or colonoscopy at 5 or 10 years, whereas surveillance after an advanced adenoma is 3 years. Optimization of surveillance reduces the risk of colorectal cancer (CRC) with efficient use of colonoscopy resources. We assessed the risks of advanced colorectal neoplasia following a baseline finding of a small adenoma compared with advanced adenoma. PATIENTS AND METHODS: A retrospective audit was undertaken of patients enrolled in a CRC surveillance program, wherein regular colonoscopies and screening with faecal immunochemical test (FIT) were provided...
January 21, 2019: European Journal of Gastroenterology & Hepatology
Tia Goss Sawhney, Bruce S Pyenson, David Rotter, Michele Berrios, Judy Yee
Background: Computed tomography (CT) colonography's effectiveness, its associated patient advantages, and its potential role to increase colorectal cancer (CRC) screening rates have been demonstrated in previous research, but whether CT colonography has a cost advantage relative to optical colonoscopy for the commercially insured US population has not been assessed. Objective: To compare the costs of CRC screening using CT colonography or optical colonoscopy for commercially insured people in the United States...
October 2018: American Health & Drug Benefits
Chen Chen, Christian Stock, Michael Hoffmeister, Hermann Brenner
BACKGROUND AND AIMS: Recent guidelines on colorectal cancer (CRC) screening recommend starting screening earlier than before. We performed a simulation study to examine and compare the optimal ages to have once-only screening colonoscopy and repeated colonoscopies. METHODS: A Markov model was set up using data from the German national screening colonoscopy registry to simulate the natural history of the adenoma-carcinoma process. CRC deaths and years of potential life lost (YPLL) for a hypothetical unscreened 50-year-old German population were estimated when they have a single screening colonoscopy or 2 or 3 screening colonoscopies with 10-year intervals at various ages...
January 9, 2019: Gastrointestinal Endoscopy
Jose Mari Parungao, Charina Reyes, Nancy Jackson, Nancy Roizen, Michael Piper
Background: The rate of inadequate bowel preparation in the general population is approximately 23%. As more individuals with developmental disabilities enter late adulthood, a concomitant rise in endoscopic procedures for this population, including screening colonoscopies, is anticipated. However, there are sparse data on the adequacy of bowel preparation in patients with developmental disabilities. Methods: A retrospective analysis of 91 patients with developmental disabilities who underwent colonoscopy from 2006 to 2014 was performed...
December 2018: Gastroenterology Research
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