BACKGROUND:To the authors's knowledge, there are few published prospective cohort studies of colonoscopy complications in patients at average risk for colorectal cancer who received colorectal cancer screening from a community-based program. In this article, the authors report the rate of colonoscopy complications in the Centers for Disease Control and Prevention (CDC)'s Colorectal Cancer Screening Demonstration Program (CRCSDP), which provided colorectal cancer screening to a medically underserved population aged 50 years to 64 years for screening, diagnostic follow-up after positive stool blood tests, and surveillance purposes. METHODS: Clinical data were collected prospectively from 5 community-based colorectal cancer screening programs. Complications were identified by reviewing the standardized clinical data and medical complication reporting forms submitted by the programs to the CDC. Serious complications were defined as conditions or symptoms that resulted in hospital admission within 30 days after the procedure, including perforation, gastrointestinal bleeding requiring or not requiring blood transfusion, cardiopulmonary events, postpolypectomy syndrome, excessive abdominal pain, or death. RESULTS: A total of 3215 individuals underwent 3355 colonoscopies. Of these, 89% of the colonoscopies were conducted for screening, 9% were conducted for diagnostic follow-up, and 2% were conducted for surveillance purposes. The mean age of the individuals was 55.9 years. Eight individuals experienced serious complications, for an incidence of 2.38 per 1000 colonoscopies. Three patients experienced bowel perforations that required surgery, 1 patient was hospitalized for postpolypectomy bleeding, 3 patients experienced cardiopulmonary events, and 1 patient visited the emergency room for excessive abdominal pain and underwent surgery for an identified colorectal mass. No deaths were reported. CONCLUSIONS: In the CDC's CRCSDP, in which a total of 3215 individuals underwent 3355 colonoscopies, the overall incidence of serious complications from colonoscopy was found to be low. Cancer 2013;119(15 suppl):2849-54.

Introduction Tuberculosis (TB) continues to be a leading cause of death in Sub-Saharan Africa, including Mozambique. While diagnostic methods and total notifications are improving, significant gaps remain between total numbers of TB cases annually, and the number that are notified. The purpose of this study was to elicit Mozambican patients with drug sensitive TB (DS-TB), TB/HIV and Multi drug resistant tuberculosis (MDR-TB) understanding and assessment of the quality of care for DS-TB, HIV/TB and MDR-TB services in Mozambique, along with challenges to effectively preventing, diagnosing and treating TB. Materials and methods Qualitative data was collected via separate focus group discussions consisting of patients with DS-TB, TB/HIV and MDR-TB at four health centers in Sofala and Manica Province, Mozambique, to describe knowledge on TB, HIV and MDR-TB, and identify barriers to access and adherence to services and their recommendations for improvement. A total of 51 patients participated in 11 discussions. Content analysis was done and main themes were identified. Results Focus groups shared a number of prominent themes. Respondents identified numerous challenges including delays in diagnosis, stigma related with diagnosis and treatment, long waits at health facilities, the absence of nutritional support for patients with TB, the absence of a comprehensive psychosocial support program, and the lack of overall knowledge about TB or multi drug resistant TB in the community. Discussion TB patients in central Mozambique identified many challenges to effectively preventing, diagnosing and treating tuberculosis. Awareness strengthening in the community, continuous quality monitoring and in-service training is needed to increase screening, diagnosis and treatment for TB, HIV/TB and MDR-TB.

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Special events such as health fairs, cultural festivals and charity runs are commonly employed in the community to increase cancer screening; however, little is known about their effectiveness. The purpose of this study is to assess the activities, screening outcomes, barriers and recommendations of special events to increase breast, cervical and colorectal cancer screening. In-depth interviews were conducted nationally with 51 coordinators of events in June to September 2012. Health fairs and screening days were the most common events conducted, primarily for breast cancer education. Goals were to increase awareness of cancer screening and reach special populations. Evidence-based Community Guide strategies to increase cancer screening employed were: small media, reducing structural barriers, one-on-one education or group education. For each event that provided screening on-site or through referral, a mean of 35 breast, 28 cervical and 19 colorectal cancer screenings were reported. Coordinators made recommendations for further evaluation of special events, and most plan to conduct another special event. These data are novel and provide baseline documentation of activities and recommendations for a commonly used community-based cancer screening intervention that lacks evidence of effectiveness. Additional research to better understand the use of special events for increasing cancer screening is warranted.