Population-Based Colonoscopy Screening for Colorectal Cancer

Bretthauer, Michael; Kaminski, Michal F.; Løberg, Magnus; Zauber, Ann G.; Reguła, Jarosław; Kuipers, Ernst J.; Hernán, Miguel A.; McFadden, Eleanor; Sunde, Annike; Kalager, Mette; Dekker, Evelien; Lansdorp–Vogelaar, Iris; Garborg, Kjetil; Rupiński, Maciej; Spaander, Manon C.W.; Bugajski, Marek; Høie, Ole; Stefánsson, Tryggvi; Hoff, Geir; Adami, Hans‐Olov

doi:10.1001/jamainternmed.2016.0960

Cited by 276 publications

(238 citation statements)

References 23 publications

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“…Besides the effect of downstaging, this stagnation in survival in 2010–2014, relative to the major gains in 2000–2004 and 2005–2009, could also be explained by the nationwide implementation of TME‐surgery in those earlier periods 28. Last, the improvement in survival in the more recent years could also be caused by lead‐time bias due to earlier diagnosis through various regional screening programs 36. Importantly, survival of all stages combined still improved, showing that the increase of survival in the present data is not only the result of stage migration.…”

Section: Discussionmentioning

confidence: 99%

An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

Brouwer

Bos

Lemmens

et al. 2018

Intl Journal of Cancer

241

193

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Regarding the continuous changes in the diagnostic process and treatment of colorectal cancer (CRC), it is important to evaluate long‐term trends which are relevant in giving direction for further research and innovations in cancer patient care. The aim of this study was to analyze developments in incidence, treatment and survival for patients diagnosed with CRC in the Netherlands. For this population‐based retrospective cohort study, all patients diagnosed with CRC between 1989 and 2014 in the Netherlands were identified using data of the nationwide population‐based Netherlands Cancer Registry (n = 267,765), with follow‐up until January 1, 2016. Analyses were performed for trends in incidence, mortality, stage distribution, treatment and relative survival measured from the time of diagnosis. The incidence of both colon and rectal cancer has risen. The use of postoperative chemotherapy for Stage III colon cancer increased (14–60%), as well as the use of preoperative (chemo)radiotherapy for rectal cancer (2–66%). The administration of systemic therapy and metastasectomy increased for Stage IV disease patients. The 5‐year relative survival increased significantly from 53 to 62% for colon cancer and from 51 to 65% for rectal cancer. Ongoing advancements in treatment, and also improvement in other factors in the care of CRC patients—such as diagnostics, dedicated surgery and pre‐ and postoperative care—lead to a continuous improvement in the relative survival of CRC patients. The increasing incidence of CRC favors the implementation of the screening program, of which the effects should be monitored closely.

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Section: Discussionmentioning

confidence: 99%

An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

Brouwer

Bos

Lemmens

et al. 2018

Intl Journal of Cancer

241

193

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“…Since the study was conducted, there has been an ESGE recommendation of cold-snare polypectomy as the preferred technique for the removal of diminutive polyps ( ≤ 5 mm). This technique has high rates of complete resection, adequate tissue sampling for histology, and low complication rates [13]. …”

Section: Discussionmentioning

confidence: 99%

Adherence to European Polypectomy Guidelines: Retrospective Experience from a Tertiary Irish Hospital

Parihar

Sopheno-Falco

Maheshwari

et al. 2018

Gastrointest Tumors

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Background and Study Aim: The European guidelines for colorectal cancer screening state that snare resection should remove any polyps ≥5 mm. This study aimed to investigate if these new guidelines are adhered to in clinical practice. Patients and Methods: This study consists of patients who underwent colonoscopies in Tallaght Hospital, Dublin (AMNCH), between 2012 and 2015. The size of the polyp, the method of removal, and the subspecialty and grade of the endoscopists were all recorded. Results: 6,000 colonoscopies were reviewed and 687 (12.5%) of these patients were found to have polyps. In 655 (95%) colonoscopies, the caecum was positively identified. In all, 371 (54%) of the polyps detected were < 5 mm; resection via forceps was carried out in n405 cases (59%). Overall, 16% (n = 45) of the polyps > 5 mm underwent resection with forceps, showing that the new European guidelines are not being tightly adhered to. Conclusions: This study found an 84% compliance with polypectomy resection guidelines which is an improvement on previous studies. However, endoscopist grade significantly affected compliance and may reflect overall competency, highlighting the need for specific training in snare polypectomy techniques.

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“…15 However, the incidence of adenomas is controversial. Imperiale and associates 21 found that 17.7% of 1994 asymptomatic patients screened had at least a single adenoma, whereas Bretthauer and associates 22 reported adenoma detection rates of 30.7%, 10.4%, and 0.5% for overall adenomas, advanced adenomas, and CRC, respectively, in 94 959 asymptomatic patients. In our study, the prevalence of overall adenoma, advanced adenoma, and CRC among the pretransplant ESRD patients was 35.4%, 8.1%, and 0.2%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Chaung

Park

et al. 2017

Exp Clin Transplant

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Objectives: Transplant centers often recommend, but not necessarily require, screening colonoscopies for people over 50 years of age in accordance with the US Preventative Services Task Force guidelines for the general population. We sought to identify risk factors affecting colonoscopy results in renal failure patients undergoing kidney transplant evaluation. Materials and Methods: We retrospectively examined patients undergoing kidney transplant evaluation from 2009 to 2012 (n = 469 patients). Comparisons were made between colonoscopy reports categorized as normal (no finding or hyperplastic polyp) or abnormal (adenomatous polyp or carcinoma). Results: Of 469 patients who met the study criteria, 303 (64.6%) had normal colonoscopies and 166 (35.4%) had abnormal colonoscopies. Logistic regression analysis showed that male sex (odds ratio = 2.09; 95% confidence interval, 1.37-3.20; P = .001) and increasing age (odds ratio = 1.04; 95% confidence interval, 1.01-1.08; P = .019) were more likely to correspond to abnormal findings. Those with dialysis vintage (length of time on dialysis) up to 3 years (odds ratio = 2.10; 95% confidence interval, 1.09-4.06; P = .027) and hypertension as the cause of renal failure (odds ratio = 1.79; 95% confidence interval, 1.05-2.87; P = .002) had more abnormal findings. No differences in length of evaluation, rate of being listed for transplant, and rate of transplant were shown. Conclusions:The overall rate of adenomatous findings on colonoscopy was higher among patients with pretransplant end-stage renal disease than in the general population, as shown in other studies. Age, sex, dialysis vintage up to 3 years, and hypertensive renal failure were associated with adenomatous polyps of the colon in this study population. Because adenomatous polyp rates are high in patients with chronic kidney disease who are undergoing transplant evaluation and colonoscopic findings do not appear to delay transplant evaluations or listing rates, screening colonoscopies should be encouraged.

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Population-Based Colonoscopy Screening for Colorectal Cancer

Cited by 276 publications

References 23 publications

An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

An overview of 25 years of incidence, treatment and outcome of colorectal cancer patients

Adherence to European Polypectomy Guidelines: Retrospective Experience from a Tertiary Irish Hospital

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