Screening for Colorectal Cancer

Lin, Jennifer S; Piper, Margaret; Perdue, Leslie A; Rutter, Carolyn M.; Webber, Elizabeth M.; O’Connor, Elizabeth; Smith, Ning; Whitlock, Evelyn P

doi:10.1001/jama.2016.3332

Cited by 634 publications

(319 citation statements)

References 29 publications

(38 reference statements)

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“…The American Cancer Society, American College of Physicians, American Gastroenterology Association, European Union Health Program, and United States Preventive Services Task Force (USPTF) clinical guidelines, based on scientific evidence, recommend CRC screening for all individuals over the age of 50 even if no additional risk factors are present [2][3][4][5]. The USPTF rates CRC screening at age 50 through 75 years as ''Grade A-likely net benefit is substantial'' [6,7]. In addition, specialty guidelines recommended earlier or more frequent CRC screening for members of high-risk population groups-hereditary CRC syndromes, individuals with first-degree relatives with CRC, and patients suffering from inflammatory bowel disease [2][3][4][5].…”

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confidence: 99%

“…The USPTF rates screening for CRC in older adults aged 76-85 years as ''Grade C-likely net benefit is small'' [6,7], and recommends that adults in this age group who have never been screened for colorectal cancer would be more likely to benefit, and that screening would be most appropriate among older adults who: (1) are healthy enough to undergo treatment if colorectal cancer is detected; (2) do not have comorbid conditions that would significantly limit their life expectancy [6,7].…”

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confidence: 99%

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Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Hornbrook

Goshen²,

Choman³

et al. 2017

Dig Dis Sci

100

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Background Machine learning tools identify patients with blood counts indicating greater likelihood of colorectal cancer and warranting colonoscopy referral. Aims To validate a machine learning colorectal cancer detection model on a US community-based insured adult population. Methods Eligible colorectal cancer cases (439 females, 461 males) with complete blood counts before diagnosis were identified from Kaiser Permanente Northwest Region's Tumor Registry. Control patients (n = 9108) were randomly selected from KPNW's population who had no cancers, received at C1 blood count, had continuous enrollment from 180 days prior to the blood count through 24 months after the count, and were aged 40-89. For each control, one blood count was randomly selected as the pseudo-colorectal cancer diagnosis date for matching to cases, and assigned a ''calendar year'' based on the count date. For each calendar year, 18 controls were randomly selected to match the general enrollment's 10-year age groups and lengths of continuous enrollment. Prediction performance was evaluated by area under the curve, specificity, and odds ratios. Results Area under the receiver operating characteristics curve for detecting colorectal cancer was 0.80 ± 0.01. At 99% specificity, the odds ratio for association of a high-risk detection score with colorectal cancer was 34.7 (95% CI 28.9-40.4). The detection model had the highest accuracy in identifying right-sided colorectal cancers. Conclusions ColonFlag Ò identifies individuals with tenfold higher risk of undiagnosed colorectal cancer at curable stages (0/I/II), flags colorectal tumors 180-360 days prior to usual clinical diagnosis, and is more accurate at identifying right-sided (compared to left-sided) colorectal cancers.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Hornbrook

Goshen²,

Choman³

et al. 2017

Dig Dis Sci

100

View full text Add to dashboard Cite

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“…Colorectal cancer (CRC) is the 3 rd leading cause of cancer death among men and women in the United States (U.S.) (Lin et al, 2016). Fortunately, screening for CRC via guaiac and immunochemical-based fecal occult blood tests (FOBT/FIT), sigmoidoscopy (SIG) and colonoscopy saves lives (Lin et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…Fortunately, screening for CRC via guaiac and immunochemical-based fecal occult blood tests (FOBT/FIT), sigmoidoscopy (SIG) and colonoscopy saves lives (Lin et al, 2016). Thus, major health organizations such as the American Cancer Society and the U.S. Preventative Services Task Force (USPSTF) have put forth screening guidelines (Smith et al, 2016; U.S.…”

Section: Introductionmentioning

confidence: 99%

Reactions to online colorectal cancer risk estimates among a nationally representative sample of adults who have never been screened

et al. 2017

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Data on the public’s reactions to online tailored colorectal cancer (CRC) risk estimates is sparse. We assessed among 560 men and women aged 50–75 with no CRC screening history reactions to online tailored CRC estimated comparative risk (i.e., self vs. other their age and sex). Assessed were reactions to estimate (i.e., repeating back estimate, match between perceived comparative risk and estimate, accuracy and usefulness of estimate, emotional reactions), risk appraisals and screening intentions. 73% of the sample accurately repeated back their estimate; the match between perceived comparative risk and the estimate was lowest among those informed of being at higher risk. Higher estimates were viewed as less useful and evoked more negative emotions. Viewing the estimate as more useful and experiencing more negative emotions were related with higher risk appraisals and, in turn, screening intentions. These data indicate that adults at higher comparative risk resist accepting a higher risk status.

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“…fecal occult blood, flexible sigmoidoscopy, colonoscopy) vary in terms of sensitivity and specificity, risks, and evidence supporting their implementation. Unfortunately, no screening method has proven to reduce all-cause mortality [3]. Colonoscopy has become the gold standard, enabling removal of dysplastic lesions before progression to cancer.…”

Section: 0 Current Challenges In Colorectal Cancermentioning

confidence: 99%

Guanylate cyclase C as a target for prevention, detection, and therapy in colorectal cancer

Aka

Rappaport

Pattison

et al. 2017

Expert Review of Clinical Pharmacology

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Introduction Colorectal cancer remains the second leading cause of cancer death in the United States, and new strategies to prevent, detect, and treat the disease are needed. The receptor, guanylate cyclase C (GUCY2C), a tumor suppressor expressed by the intestinal epithelium, has emerged as a promising target. Areas Covered This review outlines the role of GUCY2C in tumorigenesis, and steps to translate GUCY2C-targeting schemes to the clinic. Endogenous GUCY2C-activating ligands disappear early in tumorigenesis, silencing its signaling axis and enabling transformation. Pre-clinical models support GUCY2C ligand supplementation as a novel disease prevention paradigm. With the recent FDA approval of the GUCY2C ligand, linaclotide, and two more synthetic ligands in the pipeline, this strategy can be tested in human trials. In addition to primary tumor prevention, we also review immunotherapies targeting GUCY2C expressed by metastatic lesions, and platforms using GUCY2C as a biomarker for detection and patient staging. Expert Commentary Results of the first GUCY2C targeting schemes in patients will become available in the coming years. The identification of GUCY2C ligand loss as a requirement for colorectal tumorigenesis has the potential to change the treatment paradigm from an irreversible disease of genetic mutation, to a treatable disease of ligand insufficiency.

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Screening for Colorectal Cancer

Abstract: IMPORTANCE Colorectal cancer (CRC) remains a significant cause of morbidity and mortality in the United States.OBJECTIVE To systematically review the effectiveness, diagnostic accuracy, and harms of screening for CRC.

Cited by 634 publications

References 29 publications

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Reactions to online colorectal cancer risk estimates among a nationally representative sample of adults who have never been screened

Guanylate cyclase C as a target for prevention, detection, and therapy in colorectal cancer

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