Colorectal cancer screening: It is not time for a radical shift

Bielawska, Barbara; Dubé, Catherine

doi:10.1503/cmaj.191566

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…The panel argued that in individuals with a risk lower than 3% over 15 years, the 26% relative risk reduction corresponds to an absolute risk reduction which may not outweigh the harms and burdens of screening 8. The guideline was criticised by some experts, who argued that the relative risk reduction of 25% in colorectal cancer incidence is considerable and should encourage “increasing screening uptake and access to organised screening” without mentioning absolute risks and benefits 10…”

Section: Considering Absolute Risks In Guidelines: Colorectal Cancer ...mentioning

confidence: 99%

What is my risk, doctor? How to convey disease risk and treatment effects

Bretthauer

Kalager

2023

BMJ

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Section: Considering Absolute Risks In Guidelines: Colorectal Cancer ...mentioning

confidence: 99%

What is my risk, doctor? How to convey disease risk and treatment effects

Bretthauer

Kalager

2023

BMJ

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“…Organised screening occurs when all eligible individuals in a defined population are invited to be screened as part of an established program. By contrast, opportunistic screening occurs outside of an organised program and can be triggered only once an individual has been in contact with a health care practitioner [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Opportunistic Colonoscopy Cancer Screening Pays off in Romania—A Single-Centre Study

Raţiu

Lupușoru

Vora³

et al. 2021

Diagnostics

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Colorectal cancer (CRC) is the third most diagnosed cancer in men (after prostate and lung cancers) and in women (after breast and lung cancer). It is the second cause of cancer death in men (after lung cancer) and the third one in women (after breast and lung cancers). It is estimated that, in EU-27 countries in 2020, colorectal cancer accounted for 12.7% of all new cancer diagnoses and 12.4% of all deaths due to cancer. Our study aims to assess the opportunistic colorectal cancer screening by colonoscopy in a private hospital. A secondary objective of this study is to analyse the adenoma detection rate (ADR), polyp detection rate (PDR), and colorectal cancer (CRC) detection rate. We designed a retrospective single-centre study in the Gastroenterology Department of Saint Mary Hospital. The study population includes all individuals who performed colonoscopies in 2 years, January 2019–December 2020, addressed to our department by their family physician or came by themselves for a colonoscopy. One thousand seven hundred seventy-eight asymptomatic subjects underwent a colonoscopy for the first time. The mean age was 59.0 ± 10.9, 59.5% female. Eight hundred seventy-three polyps were found in 525 patients. Five hundred and twenty-five had at least one polyp, 185 patients had two polyps, 87 had three polyps, and 40 patients had more than three polyps. The PDR was 49.1%, ADR 39.0%, advanced adenomas in 7.9%, and carcinomas were found in 5.4% of patients. In a country without any colorectal cancer screening policy, polyps were found in almost half of the 1778 asymptomatic patients evaluated in a single private center, 39% of cases adenomas, and 5.4% colorectal cancer. Our study suggests starting screening colonoscopy at the age of 45. A poor bowel preparation significantly impacted the adenoma detection rate.

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“…For patients who are reluctant to participate, Bielawska and Dubé suggest that providers use risk calculators and decision aids to improve uptake of screening. 1 We believe that people are entitled to know the answer to the following questions to make a decision about screening: One of the reasons our guideline has different recommendations from others is that no previous guideline has explicitly answered these questions by presenting the absolute risk of colorectal cancer and the absolute benefits of screening to reduce that risk, weighed against the burdens and harms.…”

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confidence: 99%