Reducing Mortality from Colorectal Cancer by Screening for Fecal Occult Blood

Js, Mandel; Jh, Bond; Church, Timothy R.; Dc, Snover; Gm, Bradley; Lm, Schuman; Ederer, Fred

doi:10.1056/nejm199305133281901

Cited by 2,925 publications

(1,785 citation statements)

References 20 publications

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“…We estimated this benefit by assuming that the procedure reduces the CRC-attributable mortality by 70%, which is the median estimate from the USPSTF summary 38 . Consistent with published trials, we assumed that the annual reduction in CRC mortality would not begin until 5 years after receipt of SC, since screening improves mortality by removing early stage lesions, which can take 5+ years to result in death [39][40][41] .…”

Section: Estimating the Benefit And Harms Of Screening Colonoscopymentioning

confidence: 99%

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

et al. 2011

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Section: Estimating the Benefit And Harms Of Screening Colonoscopymentioning

confidence: 99%

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

et al. 2011

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“…Screening for CRC has been shown to decrease CRC mortality for average risk as well as high-risk individuals (Atkin et al 2010;Hardcastle et al 1996;Hewitson et al 2008;Kronborg et al 1996;Mandel et al 1993;Schoen et al 2012). The American College of Physicians (ACP) recommends that clinicians assess risk for CRC in all adults, and that average-risk individuals screen for CRC using fecal occult blood testing (FOBT) annually, flexible sigmoidoscopy every 5 years, or optical colonoscopy every 10 years, beginning at age 50 and continuing until age 75 (Qaseem et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of an educational intervention on family physicians’ risk assessment and management of colorectal cancer

et al. 2014

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We developed a point-of-care tool indicating risk categories for colorectal cancer (CRC) based on family history (FH) and management recommendations tailored to risk. The study objective was to determine if this CRC Risk Triage/ Management Too would enable family physicians (FPs) to appropriately triage and make screening and genetics referral recommendations for patients with CRC FH. Baseline questionnaires were mailed to a random sample of FPs in Ontario and Newfoundland, Canada. Participants were asked to use the tool for 3 months and then complete a follow-up questionnaire. The primary outcomes were correct responses to questions regarding CRC risk category, screening method, starting age, frequency, and decision to refer to genetics, for eight clinical vignettes. The study was completed by 75/121 (62 %) participating FPs. Most (77 %) agreed they routinely recommended fecal occult blood testing for average risk patients age ≥50. This did not change significantly following the intervention. There was a significant increase in confidence in CRC risk assessment (52 % pre; 88 % post; p<0.001), correct management recommendations for patients with CRC FH (51 % pre; 84 % post; p<0.001), and improvement in total mean scores on outcome measures for all vignettes. Most demonstrates the value of point-of-care tools and illustrates a process for development, evaluation, and dissemination of tools needed by FPs if potential impacts of genomic advances are to be achieved.

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“…Identification of high-risk patients using a less invasive test would decrease the number of such procedures required. Carcinoembryonic antigen (CEA) is of proven benefit in prognosis and follow-up, but has limited sensitivity (30 -40%) for early CRC (Fletcher, 1986), whereas serial faecal occult blood testing is proven to reduce CRC mortality but suffers from significant false-negative and falsepositive rates (Hardcastle et al, 1989;Mandel et al, 1993;Kronberg et al, 1996). Stool DNA analysis for multiple targets has shown sensitivity of 71 -91% in preliminary studies and larger studies are underway (Ahlquist et al, 2000;Dong et al, 2001); however, a serum-based assay with equivalent sensitivity and specificity would be more acceptable to many patients.…”

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confidence: 99%

Identification of serum biomarkers for colon cancer by proteomic analysis

et al. 2006

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Colorectal cancer (CRC) is often diagnosed at a late stage with concomitant poor prognosis. Early detection greatly improves prognosis; however, the invasive, unpleasant and inconvenient nature of current diagnostic procedures limits their applicability. No serum-based test is currently of sufficient sensitivity or specificity for widespread use. In the best currently available blood test, carcinoembryonic antigen exhibits low sensitivity and specificity particularly in the setting of early disease. Hence, there is great need for new biomarkers for early detection of CRC. We have used surface-enhanced laser desorbtion/ionisation (SELDI) to investigate the serum proteome of 62 CRC patients and 31 noncancer subjects. We have identified proteins (complement C3a des-arg, a1-antitrypsin and transferrin) with diagnostic potential. Artificial neural networks trained using only the intensities of the SELDI peaks corresponding to identified proteins were able to classify the patients used in this study with 95% sensitivity and 91% specificity.

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Reducing Mortality from Colorectal Cancer by Screening for Fecal Occult Blood

Abstract: Annual fecal occult-blood testing with rehydration of the samples decreased the 13-year cumulative mortality from colorectal cancer by 33 percent.

Cited by 2,925 publications

References 20 publications

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

Efficacy of an educational intervention on family physicians’ risk assessment and management of colorectal cancer

Identification of serum biomarkers for colon cancer by proteomic analysis

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