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Emerging stool-based and blood-based non-invasive DNA tests for colorectalcancerscreening: The importance of cancer prevention in addition to cancer detection Colorectalcancer (CRC) screening can be undertaken utilizing a variety of distinct approaches, which provides both opportunities and confusion. Traditionally, there has often been a trade-off between the degree of invasiveness of a screening test and its ability to prevent cancer, with fecal occult blood testing (FOBT) and optical (...) colonoscopy (OC) at each end of the spectrum. CT colonography (CTC), although currently underutilized for CRC screening, represents an exception since it is only minimally invasive, yet provides accurate evaluation for advanced adenomas. More recently, the FDA approved a multi-target stool DNA test (Cologuard) and a blood-based test (Epi proColon) for average-risk CRC screening. This commentary will provide an overview of these two new non-invasive tests, including the clinical indications, mechanism
Screening for ColorectalCancer: US Preventive Services Task Force Recommendation Statement. Colorectalcancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134,000 persons will be diagnosed with the disease, and about 49,000 will die from it. Colorectalcancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectalcancer is 68 years.To update the 2008 US Preventive Services Task Force (USPSTF (...) ) recommendation on screening for colorectal cancer.The USPSTF reviewed the evidence on the effectiveness of screening with colonoscopy, flexible sigmoidoscopy, computed tomography colonography, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test in reducing the incidence of and mortality from colorectalcancer or all-cause mortality; the harms of these screening tests; and the test performance characteristics
Estimation of Benefits, Burden, and Harms of ColorectalCancerScreening Strategies: Modeling Study for the US Preventive Services Task Force. The US Preventive Services Task Force (USPSTF) is updating its 2008 colorectalcancer (CRC) screening recommendations.To inform the USPSTF by modeling the benefits, burden, and harms of CRC screening strategies; estimating the optimal ages to begin and end screening; and identifying a set of model-recommendable strategies that provide similar life-years (...) gained (LYG) and a comparable balance between LYG and screening burden.Comparative modeling with 3 microsimulation models of a hypothetical cohort of previously unscreened US 40-year-olds with no prior CRC diagnosis.Screening with sensitive guaiac-based fecal occult blood testing, fecal immunochemical testing (FIT), multitarget stool DNA testing, flexible sigmoidoscopy with or without stool testing, computed tomographic colonography (CTC), or colonoscopy starting at age 45, 50, or 55 years and ending
Colonoscopy versus Fecal Immunochemical Testing in Colorectal-CancerScreening. 27168447 2016 05 16 2016 05 12 1533-4406 374 19 2016 May 12 The New England journal of medicine N. Engl. J. Med. Colonoscopy versus Fecal Immunochemical Testing in Colorectal-CancerScreening. 1898 10.1056/NEJMx150040 eng Published Erratum United States N Engl J Med 0255562 0028-4793 N Engl J Med. 2012 Feb 23;366(8):697-706 22356323 2016 5 12 6 0 2016 5 12 6 0 2016 5 12 6 1 ppublish 27168447 10.1056/NEJMx150040
ColorectalCancer on the Decline - Why Screening Can't Explain It All. 27119236 2016 05 05 2016 08 25 1533-4406 374 17 2016 Apr 28 The New England journal of medicine N. Engl. J. Med. ColorectalCancer on the Decline--Why Screening Can't Explain It All. 1605-7 10.1056/NEJMp1600448 Welch H Gilbert HG From the VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, VT; and the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine (...) , Lebanon, NH. Robertson Douglas J DJ From the VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, VT; and the Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, NH. eng Journal Article United States N Engl J Med 0255562 0028-4793 AIM IM N Engl J Med. 2016 Aug 25;375(8):804 27557317 N Engl J Med. 2016 Aug 25;375(8):804 27557319 N Engl J Med. 2016 Aug 25;375(8):803 27557318 Aged ColorectalNeoplasms diagnosis epidemiology
Association Between Socioeconomic Status and Participation in Colonoscopy Screening Program in First Degree Relatives of ColorectalCancer Patients Approximately 15% to 25% of colorectalcancer (CRC) cases have positive family history for disease. Colonoscopy screening test is the best way for prevention and early diagnosis. Studies have found that first degree relatives (FDRs) with low socioeconomic status are less likely to participate in colonoscopy screening program.The aim of this study (...) is to determine the association between socioeconomic status and participation in colonoscopy screening program in FDRs.This descriptive cross-sectional, study has been conducted on 200 FDRs who were consulted for undergoing colonoscopy screening program between 2007 and 2013 in research institute for gastroenterology and liver disease of Shahid Beheshti University of Medical Sciences, Tehran, Iran. They were interviewed via phone by a valid questionnaire about socioeconomic status. For data analysis, chi
A Risk-Scoring System Combined With a Fecal Immunochemical Test Is Effective in Screening High-Risk Subjects for Early Colonoscopy to Detect Advanced ColorectalNeoplasms Age, sex, smoking, and family history are risk factors for colorectalcancer in Asia. The Asia-Pacific ColorectalScreening (APCS) scoring system was developed to identify subjects with a high risk for advanced neoplasm (AN). We tested an algorithm that combined APCS scores with fecal immunochemical test (FIT) in colorectal (...) with LR group, MR and HR subjects had a 3.4-fold increase and a 7.8-fold increase in risk for AN, respectively. A total of 70.6% subjects with AN (95% confidence interval: 65.6%-75.1%) and 95.1% subjects with invasive cancers (95% confidence interval: 82.2%-99.2%) were correctly instructed to undergo early colonoscopy examination.The APCS scoring system, which is based on age, sex, family history, and smoking, is a useful tool for determining risk for colorectalcancer and advanced adenoma
of colorectalcancer in 2015 (incidence 49 per 100 000 population) and that 9300 will die from the disease (mortality 17 per 100 000). 1 The incidence and mortality of colorectalcancer are low until middle age and rise rapidly there- after (Figure 1). 1,4 Most colorectalcancers appear to arise from colonic polyps that develop slowly and some- times transform to cancers. 5 This is the ration ale for screening programs that aim to reduce deaths due to colorectalcancer by detecting and remov- ing polyps (...) as a screening test for colorectalcancer. (Weak recommendation; low-quality evidence) These recommendations apply to adults aged 50 years and older who are not at high risk for colorectalcancer. They do not apply to those with previous colorectalcancer or polyps, inflammatory boweldisease, signs or symptoms of colorectalcancer, history of colorectalcancer in one or more first-degree relatives, or adults with hereditary syndromes predisposing to colorectalcancer (e.g., familial adenomatous polyposis
Cost Effectiveness of Universal Hepatitis B Virus Screening in Patients Beginning Chemotherapy for Sarcomas or GI Stromal Tumors The value of screening for hepatitis B virus (HBV) infection before chemotherapy for nonhematopoietic solid tumors remains unsettled. We evaluated the cost effectiveness of universal screening before systemic therapy for sarcomas, including GI stromal tumors (GISTs).Drawing from the National Cancer Centre Singapore database of 1,039 patients with sarcomas, we analyzed (...) the clinical records of 485 patients who received systemic therapy. Using a Markov model, we compared the cost effectiveness of a screen-all versus screen-none strategy in this population.A total of 237 patients were screened for HBV infection. No patients developed HBV reactivation during chemotherapy. The incremental cost-effectiveness ratio per quality-adjusted life-year (QALY) of offering HBV screening to all patients with sarcomas and patients with GISTs exceeded the cost-effectiveness threshold of SG
be substantial. As such, the benefit of early detection of and intervention for colorectalcancer in adults 86 years and older is at most small. To date, no method of screening for colorectalcancer has been shown to reduce all-cause mortality in any age group. Harms CTFPHC (2016) False-positive and false-negative results were the only direct harms reported for gFOBT and FIT in the included studies. Harms following FS were rare (intestinal perforation occurred in 0.001% of patients, minor bleeding in 0.05 (...) Screening for ColorectalCancer* Screening for ColorectalCancer | National Guideline Clearinghouse success fail JUL Aug 12 2018 2019 30 Jan 2017 - 14 Jul 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused with the archive.org Archive-It Team) is a rogue archivist collective dedicated to saving copies of rapidly dying or deleted websites for the sake of history and digital heritage. The group is 100% composed of volunteers and interested parties, and has
screening in Australia, however, due to the rapidly evolving evidence base around a number of these tests, HealthPACT recommended that this technology be reassessed in 24 months. Description of the technology Bowelcancer, which includes cancers of the colon, recto-sigmoid junction and rectum, is a major cause of morbidity and mortality in Australia. Although colonoscopy is the gold standard for the detection of colorectalcancer (CRC), it is expensive, and by virtue of its invasive nature, associated (...) generation FOBT - an automated immunochemical faecal occult blood test (iFOBT). 4 Faecal occult blood testing looks for minute traces of haemoglobin in stool samples, which may be a result of upper or lower gastrointestinal bleeding potentially caused by not only benign or malignant growths or polyps of the colon, but many conditions including: inflammatory boweldisease, haemorrhoids, ulcerative colitis or Crohn’s disease. The gFOBT uses hydrogen peroxide, which in the presence of blood results
Invitation and decision aid for bowelcancerscreening Einladungsschreiben und Entscheidungshilfen zum Darmkrebs-Screening; Abschlussbericht; Auftrag P15-01 [Invitation and decision aid for bowelcancerscreening] Einladungsschreiben und Entscheidungshilfen zum Darmkrebs-Screening; Abschlussbericht; Auftrag P15-01 [Invitation and decision aid for bowelcancerscreening] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen Record Status This is a bibliographic record of a published (...) health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. Einladungsschreiben und Entscheidungshilfen zum Darmkrebs-Screening; Abschlussbericht; Auftrag P15-01. [Invitation and decision aid for bowelcancerscreening] Cologne: Institut fuer Qualitaet und Wirtschaftlichkeit im Gesundheitswesen (IQWiG). IQWiG-Berichte 451. 2016 Final publication URL
excision or simple polypectomy for tumors limited to the colonic mucosa or surgical resection (via laparoscopy or open approach) with anastomosis for larger, localized lesions. Other Approaches to Prevention The USPSTF has made a recommendation on aspirin use for the primary prevention of cardiovascular disease and colorectalcancer in average-risk adults ( ). Implementation Colorectalcancer causes substantial morbidity and mortality, and the evidence is convincing that screening for colorectalcancer (...) and older. Treatment and Interventions Treatment of early-stage colorectalcancer generally consists of local excision or simple polypectomy for tumors limited to the colonic mucosa or surgical resection (via laparoscopy or open approach) with anastomosis for larger, localized lesions. Balance of Benefits and Harms The USPSTF concludes with high certainty that the net benefit of screening for colorectalcancer is substantial. The USPSTF concludes with moderate certainty that the net benefit of screening
neoplasms/ or uterine cervical neoplasms/ or carcinoma, ductal, breast/ or "hereditary breast and ovarian cancer syndrome"/ or inflammatory breast neoplasms/ or colonicneoplasms/ or rectal neoplasms/) and (di or pc).fs. ((adenoma* or neoplasia or cancer* or neoplasm* or tumo?r* or carcinoma* or adenocarcinoma*) and (breast or cervical or cervix or colon or colorectal or crc)).ti,ab. 2 or 3 1 and 4 colonography, computed tomographic/ or colonoscopy/ or endoscopy, gastrointestinal/ or sigmoidoscopy (...) , or colorectalcancerscreening in high-income countries: PubMED Medline PsycINFO Embase CINAHL Cochrane Chronic Disease Prevention Web of Science Search strategies were adjusted to each database, based on controlled and uncontrolled vocabularies and search software. Following are the search strategies used in Medline. Databases : Medline mass screening/ or multiphasic screening/ or (screen or screened or screening).ti,ab. or "early detection of cancer"/ (neoplasms/ or breast neoplasms/ or colorectal
is to explore the possibility of risk stratification on the basis of an increased familial risk within the existing population screening programme for bowelcancer. About 6,000 people who receive an invitation for colorectalcancerscreening in the Amsterdam region in 2015 and 2016 will be invited. In a prior advisory report from the Health Council in 2009, the importance of further research on risk stratification within the population screening programme was already endorsed. The Committee notes (...) publication URL Indexing Status Subject indexing assigned by CRD MeSH ColorectalNeoplasms; Genetic Predisposition to Disease; Mass Screenings; Occult Blood; Population Surveillance; Risk Assessment; Risk Factors Language Published English Country of organisation Netherlands English summary An English language summary is available. Address for correspondence Postbus 16052, 2500 BB Den Haag, The Netherlands. Tel: +31 70 340 7520;Fax: +31 70 340 7523 Email: firstname.lastname@example.org AccessionNumber 32015001017 Date
Medical Centre in Amsterdam for a study within the regular population based screening programme for colorectalcancer. The study aims to study if the faecal test FOB-Gold is not inferior to the faecal test OC-Sensor and is therefore safe to use in the national population based screening programme for colorectalcancer in the Netherlands. Final publication URL PubMedID Indexing Status Subject indexing assigned by NLM MeSH Adult; Aged; ColorectalNeoplasms /diagnosis; Feces /chemistry; Hemoglobins (...) Population Screening Act: study of faecal tests within the population based screening programme for colorectalcancer Population Screening Act: study of faecal tests within the population based screening programme for colorectalcancer Population Screening Act: study of faecal tests within the population based screening programme for colorectalcancer Health Council of the Netherlands Record Status This is a bibliographic record of a published health technology assessment. No evaluation
Variation in Adenoma Detection Rate and the Lifetime Benefits and Cost of ColorectalCancerScreening: A Microsimulation Model. Colonoscopy is the most commonly used colorectalcancerscreening test in the United States. Its quality, as measured by adenoma detection rates (ADRs), varies widely among physicians, with unknown consequences for the cost and benefits of screening programs.To estimate the lifetime benefits, complications, and costs of an initial colonoscopy screening program (...) of patients with adenoma.Estimated lifetime colorectalcancer incidence and mortality, number of colonoscopies, complications, and costs per 1000 patients, all discounted at 3% per year and including 95% confidence intervals from multiway probabilistic sensitivity analysis.In simulation modeling, among unscreened patients the lifetime risk of colorectalcancer incidence was 34.2 per 1000 (95% CI, 25.9-43.6) and risk of mortality was 13.4 per 1000 (95% CI, 10.0-17.6). Among screened patients, simulated