The IARC Perspective on Colorectal Cancer Screening

Lauby‐Secretan, Béatrice; Vilahur, Nadia; Bianchini, Franca; Guha, Neela; Straif, Kurt

doi:10.1056/nejmsr1714643

Cited by 262 publications

(191 citation statements)

References 64 publications

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“…In the U.S., any of several tests (including FIT, high-sensitivity guaiac-based fecal blood tests, the multi-target stool DNA test, computed tomographic colonography, sigmoidoscopy, and colonoscopy) is recommended by the U.S. Preventive Services Task Force with no preference for any single test [4]. This lack of preference arises from absence of direct comparative evidence between or among the several tests [23], and because of the need to consider the tradeoffs among the tests for any individual person. Providers in this study acknowledged the potential of the risk prediction tool to help initiate the discussion about CRC screening so that the tradeoffs among tests could be considered within the context of patient risk for advanced neoplasia.…”

Section: Discussionmentioning

confidence: 99%

A risk prediction tool for colorectal cancer screening: a qualitative study of patient and provider facilitators and barriers

Matthias

Imperiale

2020

BMC Fam Pract

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Background: Despite proven effectiveness of colorectal cancer (CRC) screening, at least 35% of screen-eligible adults are not current with screening. Decision aids and risk prediction tools may help increase uptake, adherence, and efficiency of CRC screening by presenting lower-risk patients with options less invasive than colonoscopy. The purpose of this qualitative study was to determine patient and provider perceptions of facilitators and barriers to use of a risk prediction tool for advanced colorectal neoplasia (CRC and advanced, precancerous polyps), to maximize its chances of successful clinical implementation. Methods: We conducted qualitative, semi-structured interviews with patients aged 50-75 years who were not current with CRC screening, and primary care providers (PCPs) at an academic and a U.S. Department of Veterans Affairs Medical Center in the Midwest from October 2016 through March 2017. Participants were asked about their current experiences discussing CRC screening, then were shown the risk tool and asked about its acceptability, barriers, facilitators, and whether they would use it to guide their choice of a screening test. The constant comparative method guided analysis. Results: Thirty patients and PCPs participated. Among facilitators were the tool's potential to increase screening uptake, reduce patient risk, improve resource allocation, and facilitate discussion about CRC screening. PCPidentified barriers included concerns about the tool's accuracy, consistency with guidelines, and time constraints. Conclusions: Patients and PCPs found the risk prediction tool useful, with potential to increase uptake, safety, and efficiency of CRC screening, indicating potential acceptability and feasibility of implementation into clinical practice.

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Section: Discussionmentioning

confidence: 99%

A risk prediction tool for colorectal cancer screening: a qualitative study of patient and provider facilitators and barriers

Matthias

Imperiale

2020

BMC Fam Pract

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“…As a result, major advances were made in the steps leading to diagnosis. For example, qualitative gFOBTs have been replaced by quantitative FIT, 6,20,29 and the introduction of molecular tests presents new opportunities. 30 The detection of neoplasia was seen in a public health framework as being the product of access, participation, and test sensitivity, together with program principles of feasibility, acceptability, and equity.…”

Section: What Emerged From This Networkmentioning

confidence: 99%

“…1,24,29,[33][34][35][36] To achieve feasibility within the local health-care environment, 2 types of public health, WHO and IARC principle-consistent programs emerged (in contrast to ad hoc opportunistic screening): population-based organized screening (PBOS) and structured opportunistic screening (SOS). 6,25,34 PBOS has an explicit policy; a team responsible for organization, Figure 1.Current status and trends in the worldwide incidence of colorectal cancer. Geographical variation in the estimated age-standardized incidence rates of colorectal cancer (both sexes, ages 0-85 years).…”

Section: Global Explosion In Screening Activitiesmentioning

confidence: 99%

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The Global Paradigm Shift in Screening for Colorectal Cancer

2019

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“…CRC mortality is reduced through reduced incidence or the detection of occult cancers during screening. On the basis of the RCT evidence supporting the efficacy of stool testing and structural examinations, the evidence of benefit for all other analogous screening tests has been accepted based on observational studies of test performance data demonstrating the ability to detect early‐stage CRC and/or advanced adenomas …”

Section: Colorectal Cancermentioning

confidence: 99%

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

Wender

Brawley

Fedewa

et al. 2018

CA A Cancer J Clinicians

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From the mid‐20th century, accumulating evidence has supported the introduction of screening for cancers of the cervix, breast, colon and rectum, prostate (via shared decisions), and lung. The opportunity to detect and treat precursor lesions and invasive disease at a more favorable stage has contributed substantially to reduced incidence, morbidity, and mortality. However, as new discoveries portend advancements in technology and risk‐based screening, we fail to fulfill the greatest potential of the existing technology, in terms of both full access among the target population and the delivery of state‐of‐the art care at each crucial step in the cascade of events that characterize successful cancer screening. There also is insufficient commitment to invest in the development of new technologies, incentivize the development of new ideas, and rapidly evaluate promising new technology. In this report, the authors summarize the status of cancer screening and propose a blueprint for the nation to further advance the contribution of screening to cancer control.

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The IARC Perspective on Colorectal Cancer Screening

Cited by 262 publications

References 64 publications

A risk prediction tool for colorectal cancer screening: a qualitative study of patient and provider facilitators and barriers

A risk prediction tool for colorectal cancer screening: a qualitative study of patient and provider facilitators and barriers

The Global Paradigm Shift in Screening for Colorectal Cancer

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

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