Baseline Findings of the Italian Multicenter Randomized Controlled Trial of "Once-Only Sigmoidoscopy"--SCORE

Segnan, Nereo; Senore, Carlo; Andreoni, Bruno; Aste, H.; Bonelli, Luigina; Crosta, C.; Ferraris, R.; Gasperoni, Stefano; Penna, A. Michael La; Risio, Mauro; Rossini, Francesco Paolo; Sciallero, Stefania; Zappa, Marco; Atkin, Wendy

doi:10.1093/jnci/94.23.1763

Cited by 215 publications

(156 citation statements)

References 42 publications

Supporting

Mentioning

130

Contrasting

Unclassified

Order By: Relevance

“…The putative false positive rate may therefore comprise a small number of not yet diagnosed CRC 12 (46) 11 (29) 398 (44) 4566 (46) 430 7 (27) 4 (11) 262 (29) 2564 (26) Current smoking status Non-smoker 23 (88) 33 (87) 742 (83) 8053 (83) Smoker 3 (12) 5 (13) 154 (17) 1652 (17) Family history of CRC At least 1 first degree relative with CRC NR NR 68 (7) 904 ( patients. The prevalence of undiagnosed CRC in this age group has been reported to be below 1% (Imperiale et al, 2000;Segnan et al, 2002). Model calculations showed that specificity increases from 73.0 to 73.3% and 73.5% assuming a prevalence of undiagnosed CRC of 0, 0.5% and 1.0%, respectively (see Appendix B).…”

Section: Discussionmentioning

confidence: 92%

Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients

et al. 2007

View full text Add to dashboard Cite

Stool testing based on tumour-derived markers might offer a promising approach for non-invasive colorectal cancer (CRC) screening. The aim of this study was to estimate the potential of a new test for faecal tumour M2-PK to discriminate patients with CRC from a large sample of unselected older adults. Faecal tumour M2-PK concentrations were determined in 65 CRC patients and in a population-based sample of 917 older adults (median age: 65 and 62 years, respectively). Sensitivity and specificity of the test were calculated at different cutoff values, and receiver-operating characteristic curves (ROC) were constructed to visualise the discriminatory power of the test. The median (interquartile range) faecal tumour M2-PK concentration was 8.6 U ml À1 (2.8 -18.0) among CRC patients and o2 U ml À1 (o2 -3.2; Po0.0001) in the population sample. At a cutoff value of 4 U ml À1 , sensitivity (95% confidence interval) was 85% (65 -96%) for colon cancer and 56% (41 -74%) for rectum cancer. Specificity (95% confidence interval) was estimated to be 79% (76 -81%). Given the comparatively high sensitivity of the tumour M2-PK stool test (especially for colon cancer) and its simple analysis, the potential use of the test for early detection of CRC merits further investigation. Possibilities to enhance specificity of the test should be explored. Colorectal cancer (CRC) is one of the leading causes of cancerrelated morbidity and mortality worldwide (Ferlay et al, 2004). Even in countries where up-to-date therapeutic options are available, more than 40% of CRC patients still die from the disease within 5 years after diagnosis (Brenner, 2002;Brenner et al, 2005). As survival is considerably better for early, localised CRC than for later stages and CRC might be prevented altogether by detection and removal of precancerous lesions, enhanced screening will be of crucial importance for further progress in reducing the burden of the disease.Experience with faecal occult blood testing (FOBT) has shown the possibility of reducing both incidence and mortality owing to screening based on stool tests (Hardcastle et al, 1996;Mandel et al, 1999Mandel et al, , 2000 and the advantages of this screening modality regarding acceptability and practicality compared with invasive screening options. However, given the limitations of FOBT, mainly the inherently low sensitivity to detect precancerous or cancerous lesions, there is still need for improvement. Therefore, the development of stool tests with better performance characteristics has become a focus of current research, both in the field of DNAbased stool markers and in the field of protein-based stool markers. For some of the new tests, preliminary results regarding sensitivity and specificity are encouraging but evidence of the performance of the new methods is mostly restricted to small-scale investigations in the clinical setting (Haug and Brenner, 2005a).A novel approach based on the detection of proteins in stool derived from neoplastic colonocytes is the quantitative measurement of faecal tum...

show abstract

Section: Discussionmentioning

confidence: 92%

Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients

et al. 2007

View full text Add to dashboard Cite

show abstract

“…The results of four ongoing RCTs of fl exible sigmoidoscopy are expected to be reported in the next several years [4][5][6][7]. There is evidence from case-control studies to suggest that endoscopic screening reduces colorectal cancer incidence, although these studies are prone to overestimate the effectiveness of screening tests when compared with RCTs [8,9].…”

Section: Answer 7 Both Have Fallen In Recent Yearsmentioning

confidence: 99%

Test Your Knowledge: Ten Questions about Colorectal Cancer Screening

Yamey¹

2006

PLoS Med

View full text Add to dashboard Cite

It is the third most common malignancy, after lung cancer and breast cancer It is the second most common malignancy, after lung cancer It is the most common malignancy Question 3. Which of the following is true about gender differences in rectal cancer risk?Rectal cancer is more common in women than men Rectal cancer is more common in men than women Rectal cancer affects roughly equal proportions of men and women

show abstract

“…This was considered mostly due to > 35% accumulated colonoscopy coverage of the screenees and polypectomies since FOBT itselfhas a poor performance for adenoma detection [40]. [28,32,42]. In addition, there is the large PLCO study in the USA where the first results are not expected until 2011 [43].…”

Section: Performance and Effect Of Crc Screeningmentioning

confidence: 99%

“…The sensitivity of FS greatly exceeds that of a single round of FOBT, not only for large adenomas, but also for CRC [44]. The problem with FS compared with FOBT has been poor attendance in most studies, 40% in Denmark [44], 30-49% in Sweden [45,46], 10% estimated population coverage in Italy [42] and 39% in Great Britain [32]. Poor attendance will reduce the potential effectiveness (benefit to the population) and usually also efficiency (cost-effectiveness).…”

Section: Performance and Effect Of Crc Screeningmentioning

confidence: 99%

1071 Screening for colorectal cancer

Kronborg¹

2003

European Journal of Cancer Supplements

View full text Add to dashboard Cite

Baseline Findings of the Italian Multicenter Randomized Controlled Trial of "Once-Only Sigmoidoscopy"--SCORE

Abstract: Sigmoidoscopy screening is generally acceptable to recipients and safe. The high yield of advanced adenomas is consistent with the projected impact of sigmoidoscopy screening on colorectal cancer incidence.

Cited by 215 publications

References 42 publications

Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients

Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients

Test Your Knowledge: Ten Questions about Colorectal Cancer Screening

1071 Screening for colorectal cancer

Contact Info

Product

Resources

About