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Colorectal Cancer Screening (colorectal + cancer_screening)
Selected AbstractsWhat Matters When Deciding Whether to Participate in Colorectal Cancer Screening?JOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 1 2010The Moderating Role of Time Perspective According to construal level theory (CLT), the more distant an event, the more likely it is to be represented in terms of abstract (e.g., desirability) versus concrete features (e.g., feasibility). This online study tested temporal distance effects in the context of colorectal cancer screening, which is desirable in terms of detecting cancer but relatively unpleasant. Consistent with CLT, participants in the distant future condition acquired more knowledge relating to the desirability of performing the test, attached greater weight to information emphasizing the long-term benefits, and exhibited stronger intentions to use the test. These findings suggest that the temporal distance between decision-making and behavioral execution plays an important role in the construal and application of central features of health actions. [source] Knowledge, Attitudes, Beliefs, and Personal Practices Regarding Colorectal Cancer Screening Among Health Care Professionals in Rural Colorado: A Pilot SurveyTHE JOURNAL OF RURAL HEALTH, Issue 3 2009Sun Hee Rim MPH ABSTRACT:,Purpose: This study reports the baseline knowledge, attitudes, beliefs, and personal practices of health care professionals regarding colorectal cancer (CRC) screening in the High Plains Research Network (HPRN) of rural Colorado prior to a community-based educational intervention. It also examines the association between health care staff members' knowledge, attitudes, beliefs, and personal practices for CRC screening and patient screening levels by practice. Methods: Surveys were mailed to health care professionals in the HPRN. Participating clinics (n = 21) distributed patient surveys on CRC screening to persons aged ,50 for a 2-week period in 2006. Results: The survey response rate was 81% for providers (n = 46) and 90% for nursing staff (n = 63). Only 54% of health care professionals knew CRC is a leading cause of cancer deaths. When surveyed on their attitudes toward colon cancer, 92%"strongly agreed" or "agreed" that colon cancer is preventable. About 99% (n = 107) of providers and nurses "strongly agreed" or "agreed" that testing could identify problems before colon cancer starts. Most health care professionals (61%) aged ,50 years had previously been tested and were up-to-date (52%) with screening. Provider knowledge was significantly associated with higher patient screening (P = .02), but provider attitudes and beliefs were not. Moreover, personal screening practices of health care professionals did not correlate with more patients screened. Conclusion: Background knowledge of CRC among HPRN health care professionals could be improved. The results of this pilot study may help focus effective approaches such as increasing provider knowledge to enhance CRC screening in the relevant population. [source] Promoting Colorectal Cancer Screening: Which Interventions Work?CA: A CANCER JOURNAL FOR CLINICIANS, Issue 4 2009Mary Desmond Pinkowish News & Views Editor No abstract is available for this article. [source] Colorectal cancer screening: A comparison of 35 initiatives in 17 countries,,INTERNATIONAL JOURNAL OF CANCER, Issue 6 2008Victoria S. Benson Abstract Although in its infancy, organized screening for colorectal cancer (CRC) in the general population is increasing at regional and national levels. Documenting and describing these initiatives is critical to identifying, sharing and promoting best practice in the delivery of CRC screening. Subsequently, the International Colorectal Cancer Screening Network (ICRCSN) was established in 2003 to promote best practice in the delivery of organized screening programs. The initial aim was to identify and document organized screening initiatives that commenced before May 2004. Each identified initiative was sent 1 questionnaire per screening modality: fecal occult blood test, flexible sigmoidoscopy or total colonoscopy. Information was collected on screening methodology, testing details and initiative status. In total, 35 organized initiatives were identified in 17 countries, including 10 routine population-based screening programs, 9 pilots and 16 research projects. Fecal occult blood tests were the most frequently used screening modality, and total colonoscopy was seldom used as a primary screening test. The eligible age for screening ranged from 40 years old to no upper limit; most initiatives included participants aged 50 to 64. Recruitment was usually done by a mailed invitation or during a visit to a family physician. In conclusion, this is the first investigation describing the delivery of CRC screening protocols to various populations. The work of the ICRCSN is enabling valuable information to be shared and a common nomenclature to be established. © 2007 Wiley-Liss, Inc. [source] Prevalence and risk of colorectal adenoma in asymptomatic Koreans aged 40,49 years undergoing screening colonoscopyJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 3 2010Su Jin Chung Abstract Background and Aim:, Colorectal cancer screening is recommended for average-risk persons beginning at age 50. However, information about the incidence and risk factors of precursor adenoma in preceding decades is limited. The aim of this study was to determine the prevalence and risk factors of colorectal adenoma in persons aged 40,49 years and to compare the data with those aged 30,39 years and 50,59 years. Methods:, A cross-sectional study of 5254 asymptomatic subjects who underwent screening colonoscopy was conducted. Data were stratified by age into three groups: 608 aged 30,39 years, 1930 aged 40,49 years, and 2716 aged 50,59 years. Results:, Prevalence of overall adenomas was 10.4% in the 30,39 years age group, 22.2% in the 40,49 years age group, and 32.8% in the 50,59 years age group. Advanced adenoma was found in 0.7% of the 30,39 years age group, 2.7% of the 40,49 years age group, and 4.1% of the 50,59 years age group. In the 40,49 years age group, male sex and current smoking habits showed associations with low-risk adenoma after multiple adjustments. Moreover, male sex (odds ratio [OR] = 1.55, 95% confidence interval [CI]: 1.02,3.23), current smoking (OR = 1.58, 95%CI: 1.06,3.50), and family history of colorectal cancer (OR = 2.54, 95%CI: 1.16,5.56) were independent predictors of advanced adenoma in this age group. Conclusions:, Prevalence of adenoma in subjects aged 40,49 years was higher than in previous studies. Male sex and current smoking habits along with a family history of colorectal cancer were associated with advanced adenoma in this age group. [source] As tests evolve and costs of cancer care rise: reappraising stool-based screening for colorectal neoplasiaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2008M. PAREKH Summary Background, Colorectal cancer screening and treatment are rapidly evolving. Aims, To reappraise stool-based colorectal cancer screening in light of changing test performance characteristics, lower test cost and increasing colorectal cancer care costs. Methods, Using a Markov model, we compared faecal DNA testing every 3 years, annual faecal occult blood testing or immunochemical testing, and colonoscopy every 10 years. Results, In the base case, faecal occult blood testing and faecal immunochemical testing gained life-years/person and cost less than no screening. Faecal DNA testing version 1.1 at $300 (the current PreGen Plus test) gained 5323 life-years/100 000 persons at $16 900/life-year gained and faecal DNA testing version 2 (enhanced test) gained 5795 life-years/100 000 persons at $15 700/life-year gained vs. no screening. In the base case and most sensitivity analyses, faecal occult blood testing and faecal immunochemical testing were preferred to faecal DNA testing. Faecal DNA testing version 2 cost $100 000/life-year gained vs. faecal immunochemical testing when per-cycle adherence with faecal immunochemical testing was 22%. Faecal immunochemical testing with excellent adherence was superior to colonoscopy every 10 years. Conclusions, As novel biological therapies increase colorectal cancer treatment costs, faecal occult blood testing and faecal immunochemical testing could become cost-saving. The cost-effectiveness of faecal DNA testing compared with no screening has improved, but faecal occult blood testing and faecal immunochemical testing are preferred to faecal DNA testing when patient adherence is high. Faecal immunochemical testing may be comparable to colonoscopy every 10 years in persons adhering to yearly testing. [source] Colorectal cancer screening and rural Australian communitiesAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2010David P. Weller No abstract is available for this article. [source] What Matters When Deciding Whether to Participate in Colorectal Cancer Screening?JOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 1 2010The Moderating Role of Time Perspective According to construal level theory (CLT), the more distant an event, the more likely it is to be represented in terms of abstract (e.g., desirability) versus concrete features (e.g., feasibility). This online study tested temporal distance effects in the context of colorectal cancer screening, which is desirable in terms of detecting cancer but relatively unpleasant. Consistent with CLT, participants in the distant future condition acquired more knowledge relating to the desirability of performing the test, attached greater weight to information emphasizing the long-term benefits, and exhibited stronger intentions to use the test. These findings suggest that the temporal distance between decision-making and behavioral execution plays an important role in the construal and application of central features of health actions. [source] Using iron deficiency tests for colorectal cancer screening: a feasibility study in one UK general practiceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2004Adrian Edwards PhD MRCGP MRCP Abstract Iron deficiency is common at presentation in colorectal cancer. Testing for it may complement other screening tests such as faecal occult blood testing and sigmoidoscopy. We therefore examined the feasibility of offering iron deficiency testing to patients in a primary care setting in the UK, offering testing to all 1240 patients aged 55,74 years in one general practice in South Wales, UK. Patients with abnormal results were assessed and offered further investigations. Five hundred and fifty-one people (44.4%) attended for iron deficiency blood tests, of whom 26 patients (4.7%) were iron deficient and offered endoscopic assessment. This identified two cases of benign neoplasia amenable to treatment and no cases of cancer. Iron deficiency testing in a screening context appeared feasible although uptake may be low. [source] Repeat participation in colorectal cancer screening utilizing fecal occult blood testing: A community-based project in a rural settingJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2010Monika Janda Abstract Background and Aim:, To investigate participation in a second round of colorectal cancer screening using a fecal occult blood test (FOBT) in an Australian rural community, and to assess the demographic characteristics and individual perspectives associated with repeat screening. Methods:, Potential participants from round 1 (50,74 years of age) were sent an intervention package and asked to return a completed FOBT (n = 3406). Doctors of participants testing positive referred to colonoscopy as appropriate. Following screening, 119 participants completed qualitative telephone interviews. Multivariable logistic regression models evaluated the association between round-2 participation and other variables. Results:, Round-2 participation was 34.7%; the strongest predictor was participation in round 1. Repeat participants were more likely to be female; inconsistent screeners were more likely to be younger (aged 50,59 years). The proportion of positive FOBT was 12.7%, that of colonoscopy compliance was 98.6%, and the positive predictive value for cancer or adenoma of advanced pathology was 23.9%. Reasons for participation included testing as a precautionary measure or having family history/friends with colorectal cancer; reasons for non-participation included apathy or doctors' advice against screening. Conclusion:, Participation was relatively low and consistent across rounds. Unless suitable strategies are identified to overcome behavioral trends and/or to screen out ineligible participants, little change in overall participation rates can be expected across rounds. [source] A comparison of the acceptance of immunochemical faecal occult blood test and colonoscopy in colorectal cancer screening: a prospective study among ChineseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2010M. C. S. Wong Aliment Pharmacol Ther 2010; 32: 74,82 Summary Background, Preferences to choose immunochemical faecal occult blood test (FIT) and colonoscopy as colorectal cancer (CRC) screening modalities among asymptomatic Chinese subjects remain unknown. Aim, To evaluate the preference of choosing colonoscopy vs. FIT among CRC screening participants. Methods, From a community-based CRC screening programme for asymptomatic Hong Kong Chinese aged 50,70 years, participants attended standardized educational sessions and chose the options of annual FIT for 5 years or direct colonoscopy once. Factors associated with choosing colonoscopy were evaluated by multivariate regression analysis. Results, Among 3430 participants [mean age 56.8 years (s.d. 5.0); female 55.1%, male 44.9%], 51.3% chose colonoscopy and 48.7% chose FIT. Older participants (65,70 years) were less likely to choose colonoscopy [adjusted odds ratio (aOR) 0.731, P = 0.041]. Subjects who chose colonoscopy were those disagreed screening would lead to discomfort (aOR 1.356, P < 0.001), had relatives or friends who had CRC (first degree relatives aOR 1.679, P < 0.001; second degree relatives aOR 1.304, P = 0.019; friends or others aOR 1.252, P = 0.026) and those who self-perceived their health as poor (aOR 1.529, P = 0.025). Conclusions, Faecal occult blood test and direct colonoscopy were equally preferable to Chinese. Colonoscopy was preferred among the younger subjects, those with positive family history of CRC and self-perceived poor health status. [source] Systematic review: distribution of advanced neoplasia according to polyp size at screening colonoscopyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010C. HASSAN Summary Background, The impact of not referring sub-centimetre polyps identified at CT colonography upon the efficacy of colorectal cancer screening remains uncertain. Aim, To determine the distribution of advanced neoplasia according to polyp size in a screening setting. Methods, Published studies reporting the distribution of advanced adenomas in asymptomatic screening cohorts according to polyp size were identified by MEDLINE and EMBASE searches. Predefined outputs were the screening rates of advanced adenomas represented by diminutive (,5 mm), small (6,9 mm), sub-centimetre (<10 mm) and large (,10 mm) polyp sizes. Results, Data from four studies with 20 562 screening subjects met the primary inclusion criteria. Advanced adenomas were detected in 1155 (5.6%) subjects (95% CI = 5.3,5.9), corresponding to diminutive, small and large polyps in 4.6% (95% CI = 3.4,5.8), 7.9% (95% CI = 6.3,9.4) and 87.5% (95% CI = 86,89.4) of cases respectively. The frequency of advanced lesions among patients whose largest polyp was diminutive, small, sub-centimetre and large in size was 0.9%, 4.9%, 1.7% and 73.5% respectively. Conclusions, Based on this systematic review, a 6-mm polyp size threshold for polypectomy referral would identify over 95% of subjects with advanced adenomas, whereas a 10-mm threshold would identify 88% of cases. Aliment Pharmacol Ther,31, 210,217 [source] The views of gastroenterologists about the role of nurse endoscopists, especially in colorectal cancer screeningALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 8 2009P. G. VAN PUTTEN Summary Background, Nurse endoscopists may provide a solution for the insufficient endoscopic capacity in colorectal cancer (CRC) screening. Aim, To determine the views of gastroenterologists about the potential role of nurse endoscopists in gastrointestinal endoscopy. Methods, A postal questionnaire was sent to all registered gastroenterologists (n = 301) and gastroenterology residents (n = 79) in the Netherlands. Results, Two hundred and thirty five of 380 (62%) gastroenterologists and residents completed the questionnaire. Overall, 48% were positive towards introduction of nurse endoscopists, whereas 18% were neutral and 34% negative. Respondents expected no major differences in endoscopic quality between physicians and nurse endoscopists. Nevertheless, 69% expected that patient experiences would be better met by physicians. Multivariate analysis showed that actual experience with nurse endoscopists and beliefs that nurse endoscopists are able to provide adequate endoscopic quality and good patient experiences, were independent predictors for a positive attitude towards introduction of nurse endoscopists [OR 6.6 (2.3,18.4), OR 1.9 (1.2,3.5) and OR 2.1 (1.2,2.9), respectively]. Respectively 89% and 66% of the respondents considered sigmoidoscopy and colonoscopy for CRC screening as appropriate procedures to be performed by nurse endoscopists. Diagnostic and therapeutic endoscopies were considered less appropriate. Conclusion, A majority of gastroenterologists have a positive attitude towards introduction of nurse endoscopists, especially for CRC screening endoscopies. [source] Projected impact of colorectal cancer screening with computerized tomographic colonography on current radiological capacity in EuropeALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2008C. HASSAN Summary Background, The impact of a primary colorectal cancer screening with computerized tomographic colonography on current radiological capacity is unknown. The multispecialty needs for computerized tomographic examinations raise some doubts on the feasibility of a mass colorectal cancer screening with computerized tomographic colonography. Aim, To assess whether the number of available computerized tomographic units in Europe is adequate to cover population screening with computerized tomographic colonography. Methods, A mathematical and a Markov model were, respectively, used to assess the number of computerized tomographic colonography procedures needed to be performed each day in the start-up and in the steady-state phases of a colorectal cancer screening programme in Europe. Such outcome was divided for the total number of computerized tomographic machines aged <10 years estimated to be present in the European hospitals. Results, At a simulated 30% compliance, 28 760 130 European people would need to be screened by the 3482 available computerized tomographic units in a 5-year start-up period, corresponding to 6.6 CTC/CT unit/day. Assuming a 10-year repetition of computerized tomographic colonography between 50 and 80 years, the number of computerized tomographic colonography needed to be performed in the steady-state period appeared to be 4.3/CT unit/day. Conclusions, The current radiological capacity may cover the need for a primary colorectal cancer screening with computerized tomographic colonography in a steady state. On the other hand, a substantial implementation of the current computerized tomographic capacity or a synergistic approach with other techniques seems to be necessary for the start-up period. [source] Exploratory study examining barriers to participation in colorectal cancer screeningAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 1 2010Johanna S. Paddison Abstract Objective:,To examine the Stage of Change distribution for bowel cancer screening in a regional Australian community and the factors associated with varying positions on the continuum of change. Design:,Survey of a convenience sample. Setting:,Community sample. Participants:,A total of 59 (31 male, mean age = 59) service club members from a South Australian regional community. Main outcome measure:,Self-reported Stage of Change for bowel cancer screening behaviour. Results:,Attributing greater embarrassment and discomfort to bowel cancer screening was associated with earlier positions on the Stages of Change. Perceiving that bowel cancer screening might have positive value for personal health was associated with more advanced positions on the continuum of change. Those who perceived breast and prostate screening procedures to be embarrassing or to cause discomfort were significantly less likely to be participating in bowel cancer screening. No significant relationships were found between bowel cancer screening Stage of Change and worry about vulnerability; personal, family or wider social network case reports of bowel cancer; and the population-level value attributed to the cancer screening procedures. Conclusion:,Bowel cancer screening participation rates are currently lower than those associated with breast and prostate screening. Reducing perceptions of embarrassment and discomfort, increasing awareness of potential health benefits and maximising participation in other screening procedures might increase participation in bowel cancer screening. [source] Underuse of colorectal cancer screening among men screened for prostate cancerCANCER, Issue 20 2010A teachable moment? Abstract BACKGROUND: Evidence suggests that colorectal cancer (CRC) screening reduces disease-specific mortality, whereas the utility of prostate cancer screening remains uncertain. However, adherence rates for prostate cancer screening and CRC screening are very similar, with population-based studies showing that approximately 50% of eligible US men are adherent to both tests. Among men scheduled to participate in a free prostate cancer screening program, the authors assessed the rates and correlates of CRC screening to determine the utility of this setting for addressing CRC screening nonadherence. METHODS: Participants (N = 331) were 50 to 70 years old with no history of prostate cancer or CRC. Men registered for free prostate cancer screening and completed a telephone interview 1 to 2 weeks before undergoing prostate cancer screening. RESULTS: One half of the participants who underwent free prostate cancer screening were eligible for but nonadherent to CRC screening. Importantly, 76% of the men who were nonadherent to CRC screening had a regular physician and/or health insurance, suggesting that CRC screening adherence was feasible in this group. Furthermore, multivariate analyses indicated that the only significant correlates of CRC screening adherence were having a regular physician, health insurance, and a history of prostate cancer screening. CONCLUSIONS: Free prostate cancer screening programs may provide a teachable moment to increase CRC screening among men who may not have the usual systemic barriers to CRC screening, at a time when they may be very receptive to cancer screening messages. In the United States, a large number of men participate in annual free prostate cancer screening programs and represent an easily accessible and untapped group that can benefit from interventions to increase CRC screening rates. Cancer 2010. © 2010 American Cancer Society. [source] Colon cancer screening practices and disclosure after receipt of positive or inconclusive genetic test results for hereditary nonpolyposis colorectal cancer,,§CANCER, Issue 18 2009Anne L. Ersig PhD Abstract BACKGROUND: Patients who receive conclusive genetic test results for hereditary nonpolyposis colorectal cancer (HNPCC) tend to adopt appropriate colorectal cancer screening behaviors and disclose their test results. However, little is known about the disclosure processes or screening behaviors of individuals who receive inconclusive genetic test results. This study compared endoscopy use and disclosure between individuals with positive and inconclusive genetic test results, within a year after results were received. METHODS: Individuals with a personal history of cancer and suspected of having HNPCC participated in genetics education and counseling, underwent HNPCC testing, and received genetic test results (GCT) within a prospective cohort study. Demographic, psychosocial, and behavioral data were obtained from questionnaires and interviews completed before and after GCT. RESULTS: Index cases with inconclusive genetic test results were less likely to screen within 12 months. Index cases who disclosed test results to children within 6 months were more likely to screen within 12 months, controlling for mutation status. Index cases with inconclusive genetic test results were less likely to share results with a healthcare provider within 6 months. Index cases who disclosed genetic test results to healthcare providers within 6 months were more likely to have endoscopy within 12 months. CONCLUSIONS: Genetic test results and disclosure significantly affected colon cancer screening at 12-month follow-up. Interventions to improve adherence to colorectal cancer screening should consider increased education of those receiving inconclusive results and encourage disclosure to healthcare providers and family members. Cancer 2009. Published 2009 by the American Cancer Society. [source] | |||||||||||||||||||||||||