The Korean guideline for colorectal cancer screening

et al. 2020

JCM

Background: The compliance with the follow-up examination after a positive fecal occult blood test (FOBT) is lower than expected. We aimed to evaluate the adherence rate to the follow-up examination in patients with a positive FOBT and to identify the clinical factors associated with this adherence. Methods: The study population comprised adults aged ≥50 years who participated in the National Cancer Screening Program for colorectal cancer (CRC) in 2013. Compliance was defined as undergoing follow-up examination within 1 year of a positive FOBT. Results: From 214,131 individuals with a positive FOBT, 120,911 (56.5%) were in the compliance group and 93,220 (43.5%) were in the non-compliance group. On multivariate analysis, good compliance was associated with men (odds ratio (OR) = 1.12, 95% confidence interval (CI) (1.09–1.15)), younger ages (70–79 years, OR = 2.19 (2.09–2.31); 60–69 years, OR = 3.29 (3.13–3.46); 50–59 years, OR = 3.57 (3.39–3.75) vs. >80 years), previous experience of CRC screening (a negative FOBT, OR = 1.18 (1.15–1.21); a positive FOBT, OR = 2.42 (2.31–2.54)), absent previous experience of colonoscopy or barium enema (OR = 2.06 (1.99–2.13)), higher economic income (quartile, 75%, OR = 1.14 (1.11–1.17); 100%, OR = 1.22 (1.19–1.25)), current smokers (OR = 1.12 (1.09–1.15)), alcohol intake (OR = 1.03 (1.01–1.05)), active physical activity (≥3 times/week, OR = 1.13 (1.11–1.15)), depression (OR = 1.11 (1.08–1.14)), and present comorbidities (Charlson Comorbidity Index, ≥1). Conclusion: This study identified clinical factors, namely, male, younger ages, prior experience of fecal test, absent history of colonoscopy or double-contrast barium enema (DCBE) within 5 years, and high socioeconomic status to be associated with good adherence to the follow-up examination after a positive FOBT.

Section: Introductionmentioning

confidence: 99%

Clinical Factors Associated with Adherence to the Follow-Up Examination after Positive Fecal Occult Blood Test in National Colorectal Cancer Screening

Kim

Kang

et al. 2020

JCM

“…Of the two FOBT methods, fecal immunochemical test (FIT) has garnered higher performance ratings and higher acceptance rates than guaiac FOBT, and thus, several countries have recently posited the adoption of FIT as a primary screening tool [ 7 , 25 , 26 ]. In Korea, newly revised CRC guidelines recommend FIT (qualitative or quantitative) and selective use of colonoscopy, taking into consideration individual preferences and the risk of CRC [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Perceptions of colorectal cancer screening and recommendation behaviors among physicians in Korea

et al. 2017

Self Cite

BackgroundPhysician recommendations for colorectal cancer (CRC) screening have consistently been shown to be a strong predictor of screening. The aim of this study was to investigate perceptions of CRC screening modalities and recommendation behaviors among physicians in Korea.MethodsA cross-sectional, nationally representative survey conducted between November 2013 and February 2014. In total, 379 physicians (241 primary care physicians and 138 physicians affiliated with the Korean Association for the Study of Intestinal Diseases responded to this survey (overall response rate of 31.4%).ResultsAbout 29% of all respondents “always” recommended and about 67% “sometimes” recommended CRC screening. Colonoscopy was perceived as an effective primary screening tool for CRC, and 80% of the physicians recommended colonoscopy for CRC screening. Only 7% recommended FOBT. In multivariate analysis, recommending FOBT was associated with stronger belief in the screening efficacy of FOBT (aOR 3.70, 95% CI 2.09, 6.57), weaker belief in the screening efficacy of colonoscopy (aOR 0.29, 95% CI 0.12, 0.69), and negative decisional balance for colonoscopy screening (aOR 0.82, 95% CI 0.71, 0.95).ConclusionsAlthough FOBT is provided free-of-charge through a nationwide CRC screening program, colonoscopy was more commonly recommended and preferred by physicians.Electronic supplementary materialThe online version of this article (10.1186/s12885-017-3881-5) contains supplementary material, which is available to authorized users.

“…On the other hand, Asia‐Pacific consensus recommendations on CRC screening state that FDRs of patients with sporadic CRC diagnosed at age < 50 years are at an increased risk of colorectal neoplasia (CRN), and early screening is warranted . However, in Korea, where the incidence of CRC, especially young‐age onset CRC, is increasing rapidly, optimal screening strategy for persons with a family history of CRC has not been fully established …”

Section: Introductionmentioning

confidence: 99%

“…5 However, in Korea, where the incidence of CRC, especially young-age onset CRC, is increasing rapidly, 6,7 optimal screening strategy for persons with a family history of CRC has not been fully established. 8,9 A further consideration is the age-specific risk of CRN in persons with a family history of CRC. Even though the risk of CRN is generally higher in persons with a family history of CRC than in those without a family history of CRC, it may not be the case for all age groups.…”

Section: Introductionmentioning

confidence: 99%

Impact of family history of colorectal cancer on age‐specific prevalence of colorectal neoplasia

Kim

J of Gastro and Hepatol

et al. 2018

Self Cite

Background and Aim There are no established guidelines on screening strategies for persons with a family history of colorectal cancer (CRC) in Korea. We aimed to evaluate the age‐specific risk of colorectal neoplasia according to family history of CRC. Methods Participants who underwent screening colonoscopy were included. Age‐specific prevalence of non‐advanced adenoma (NAA) and advanced colorectal neoplasia (ACRN) was calculated according to family history of CRC. Results Among 35 997 participants, 1339 (3.7%) had a family history of CRC in first‐degree relatives. A family history of CRC was an independent risk factor for NAA (adjusted odds ratio [AOR] 1.33, 95% confidence interval [CI] 1.16–1.52). In the subgroup analysis by age, family history of CRC was a risk factor for NAA in the 50–59 and ≥ 60 years groups (AOR [95% CI]: 1.42 [1.04–1.91] and 2.33 [1.34–4.09], respectively), but not in the 30–39 and 40–49 years groups. In the curve of age‐specific prevalence of NAA, the gap of the prevalence between the family history and non‐family history groups began to widen after the mid‐50s. In cases of ACRN, a family history of CRC was not a risk factor in the entire age group (AOR 1.16, 95% CI 0.75–1.70). In the curve of age‐specific prevalence of ACRN, however, the gap of the prevalence between the family history and non‐family history groups began to widen after the early 60s. Conclusion Although a family history of CRC is a risk factor for NAA, it may affect NAA development from the mid‐50s and ACRN development from the early 60s.