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Adenomas and hyperplastic polyps in screening studies.

https://arctichealth.org/en/permalink/ahliterature24936
Source
World J Surg. 1991 Jan-Feb;15(1):7-13
Publication Type
Article
Author
K. Bech
O. Kronborg
C. Fenger
Author Affiliation
Department of Surgical Gastroenterology, Odense University Hospital, Denmark.
Source
World J Surg. 1991 Jan-Feb;15(1):7-13
Language
English
Publication Type
Article
Keywords
Adenoma - diagnosis - epidemiology
Aged
Colonic Polyps - diagnosis - epidemiology
Colorectal Neoplasms - diagnosis - epidemiology
Denmark
Female
Humans
Intestinal Polyps - diagnosis - epidemiology
Male
Mass Screening
Middle Aged
Occult Blood
Prospective Studies
Random Allocation
Research Support, Non-U.S. Gov't
Abstract
A survey is given of colorectal polyps detected in a prospective randomized screening study with the fecal occult blood test. It is demonstrated that colonoscopy in persons with positive Hemoccult-II tests results in detection of and removal of a higher number of adenomas than among controls. The strategy may, therefore, possibly be followed by a reduction of the incidence of colorectal cancer. Screen-detected adenomas were most often in males and were larger than among controls; they were most often in the sigmoid colon, whereas the rectum was the most frequent location for adenomas in controls. Eight percent of persons with screen-detected adenomas had some symptoms, which could be referred to adenomas, in contrast to 50% among controls. Hyperplastic polyps served as markers for adenomas in persons with positive Hemoccult-II as well as in controls with adenomas detected by colonoscopy; however, most persons with adenomas had no hyperplastic polyps. Endoscopic polypectomy did not result in any severe complications, but surgical removal in 2 of 22 patients proved fatal. The results presented are compared with those of other prospective randomized trials. The optimistic view--that the incidence of cancer may be reduced by polypectomy in persons with positive Hemoccult-II tests--stresses the importance of securing optimal colonoscopy service.
PubMed ID
1994609 View in PubMed
Less detail

Analysis of administrative data finds endoscopist quality measures associated with postcolonoscopy colorectal cancer.

https://arctichealth.org/en/permalink/ahliterature140652
Source
Gastroenterology. 2011 Jan;140(1):65-72
Publication Type
Article
Date
Jan-2011
Author
Nancy N Baxter
Rinku Sutradhar
Shawn S Forbes
Lawrence F Paszat
Refik Saskin
Linda Rabeneck
Author Affiliation
Department of Surgery and Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. baxtern@smh.toronto.on.ca
Source
Gastroenterology. 2011 Jan;140(1):65-72
Date
Jan-2011
Language
English
Publication Type
Article
Keywords
Adenoma - diagnosis
Adult
Aged
Aged, 80 and over
Clinical Competence
Colonoscopy - education
Colorectal Neoplasms - diagnosis
Early Detection of Cancer - standards
Female
Humans
Male
Middle Aged
Ontario
Quality Control
Young Adult
Abstract
Most quality indicators for colonoscopy measure processes; little is known about their relationship to patient outcomes. We investigated whether characteristics of endoscopists, determined from administrative data, are associated with development of postcolonoscopy colorectal cancer (PCCRC).
We identified individuals diagnosed with colorectal cancer in Ontario from 2000 to 2005 using the Ontario Cancer Registry. We determined performance of colonoscopy using Ontario Health Insurance Plan data. Patients who had complete colonoscopies 7 to 36 months before diagnosis were defined as having a PCCRC. Patients who had complete colonoscopies within 6 months of diagnosis had detected cancers. We determined if endoscopist factors (volume, polypectomy and completion rate, specialization, and setting) were associated with PCCRC using logistic regression, controlling for potential covariates.
In the study, 14,064 patients had a colonoscopy examination within 36 months of diagnosis; 584 (6.8%) with distal and 676 (12.4%) with proximal tumors had PCCRC. The endoscopist's specialty (nongastroenterologist/nongeneral surgeon) and setting (non-hospital-based colonoscopy) were associated with PCCRC. Those who underwent colonoscopy by an endoscopist with a high completion rate were less likely to have a PCCRC (distal: odds ratio [OR], 0.73; 95% confidence interval [CI], 0.54-0.97; P = .03; proximal: OR, 0.72; 95% CI, 0.53-0.97; P = .002). Patients with proximal cancers undergoing colonoscopy by endoscopists who performed polypectomies at high rates had a lower risk of PCCRC (OR, 0.61; 95% CI, 0.42-0.89; P
Notes
Comment In: Gastroenterology. 2011 Jan;140(1):19-2121110966
PubMed ID
20854818 View in PubMed
Less detail

The appropriateness of surveillance colonoscopy intervals after polypectomy.

https://arctichealth.org/en/permalink/ahliterature116614
Source
Can J Gastroenterol. 2013 Jan;27(1):33-8
Publication Type
Article
Date
Jan-2013
Author
Eline Schreuders
Jerome Sint Nicolaas
Vincent de Jonge
Harmke van Kooten
Isaac Soo
Daniel Sadowski
Clarence Wong
Monique E van Leerdam
Ernst J Kuipers
Sander J O Veldhuyzen van Zanten
Author Affiliation
Department of Gastronenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. elineschreuders@gmail.com
Source
Can J Gastroenterol. 2013 Jan;27(1):33-8
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adenoma - diagnosis - pathology - surgery
Aged
Canada
Colonic Polyps - diagnosis - pathology - surgery
Colonoscopy - methods - standards
Colorectal Neoplasms - diagnosis - prevention & control
Female
Gastroenterology - standards
Guideline Adherence
Humans
Male
Middle Aged
Practice Guidelines as Topic
Retrospective Studies
Time Factors
Abstract
Adherence to surveillance colonoscopy guidelines is important to prevent colorectal cancer (CRC) and unnecessary workload.
To evaluate how well Canadian gastroenterologists adhere to colonoscopy surveillance guidelines after adenoma removal or treatment for CRC.
Patients with a history of adenomas or CRC who had surveillance performed between October 2008 and October 2010 were retrospectively included. Time intervals between index colonoscopy and surveillance were compared with the 2008 guideline recommendations of the American Gastroenterological Association and regarded as appropriate when the surveillance interval was within six months of the recommended time interval.
A total of 265 patients were included (52% men; mean age 58 years). Among patients with a normal index colonoscopy (n=110), 42% received surveillance on time, 38% too early (median difference = 1.2 years too early) and 20% too late (median difference = 1.0 year too late). Among patients with nonadvanced adenomas at index (n=96), 25% underwent surveillance on time, 61% too early (median difference = 1.85) and 14% too late (median difference = 1.1). Among patients with advanced neoplasia at index (n=59), 29% underwent surveillance on time, 34% too early (median difference = 1.86) and 37% later than recommended (median difference = 1.61). No significant difference in adenoma detection rates was observed when too early surveillance versus appropriate surveillance (34% versus 33%; P=0.92) and too late surveillance versus appropriate surveillance (21% versus 33%; P=0.11) were compared.
Only a minority of surveillance colonoscopies were performed according to guideline recommendations. Deviation from the guidelines did not improve the adenoma detection rate. Interventions aimed at improving adherence to surveillance guidelines are needed.
Notes
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PubMed ID
23378981 View in PubMed
Less detail

The association between location, age and advanced colorectal adenoma characteristics: a propensity-matched analysis.

https://arctichealth.org/en/permalink/ahliterature285738
Source
Scand J Gastroenterol. 2017 Jan;52(1):1-4
Publication Type
Article
Date
Jan-2017
Author
Hans-Christian Pommergaard
Jakob Burcharth
Jacob Rosenberg
Hans Raskov
Source
Scand J Gastroenterol. 2017 Jan;52(1):1-4
Date
Jan-2017
Language
English
Publication Type
Article
Keywords
Adenoma - diagnosis - pathology
Adult
Aged
Colonic Polyps - diagnosis - pathology
Colorectal Neoplasms - diagnosis - pathology
Cross-Sectional Studies
Denmark
Double-Blind Method
Female
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local - diagnosis
Propensity Score
Risk factors
Sigmoidoscopy
Abstract
Evidence supports an association between certain colorectal adenoma characteristics and predisposition to cancer. The association between anatomical location of colorectal adenoma, age and advanced adenomas needs attention. The objective of this study was to evaluate the possible association between occurrence of sporadic advanced adenomas with location and age.
A cross-sectional study using baseline data from index colonoscopy from a randomized controlled trial evaluating chemopreventive treatment against recurrence of colorectal adenomas was performed. Inclusion criteria for patients were one adenoma of >1?cm in diameter or multiple adenomas of any size, or an adenoma of any size and familial disposition for colorectal cancer. Multivariate regression and propensity score-matched analyses were used to correlate location of adenomas and age with advanced adenoma features.
In this study, 2149 adenomas were removed in 1215 patients. Advanced colorectal adenomas primarily occurred in the anal part of the colon. Older age was associated with more adenomas and more oral occurrence of adenomas, as well as a higher risk of advanced adenomas. Surprisingly, specifically for the oral adenomas the risk of advanced adenoma seems to be lower for older patients compared with younger.
This study presents new results with regard to association between age, location of adenomas and risk of advanced adenomas. The results indicate that sigmoidoscopy for screening purposes may be obsolete, and add to the existing literature on which future guidelines for screening may be based.
PubMed ID
27686516 View in PubMed
Less detail

Cancer Care Ontario Colonoscopy Standards: standards and evidentiary base.

https://arctichealth.org/en/permalink/ahliterature160042
Source
Can J Gastroenterol. 2007 Nov;21 Suppl D:5D-24D
Publication Type
Article
Date
Nov-2007
Author
L. Rabeneck
R B Rumble
J. Axler
A. Smith
D. Armstrong
C. Vinden
P. Belliveau
K. Rhodes
C. Zwaal
V. Mai
P. Dixon
Author Affiliation
Cancer Care Ontario, Toronto, Canada. linda.rabeneck@sunnybrook.ca
Source
Can J Gastroenterol. 2007 Nov;21 Suppl D:5D-24D
Date
Nov-2007
Language
English
Publication Type
Article
Keywords
Adenoma - diagnosis
Clinical Competence
Colonoscopy - standards
Colorectal Neoplasms - diagnosis
Conscious Sedation
Evidence-Based Medicine
Humans
Mass Screening - standards
Ontario
Quality Assurance, Health Care
Resuscitation
Surgical Procedures, Minimally Invasive - education
Abstract
Colorectal cancer (CRC) is the most common cause of non-tobacco-related cancer deaths in Canadian men and women, accounting for 10% of all cancer deaths. An estimated 7800 men and women will be diagnosed with CRC, and 3250 will die from the disease in Ontario in 2007. Given that CRC incidence and mortality rates in Ontario are among the highest in the world, the best opportunity to reduce this burden of disease would be through screening. The present report describes the findings and recommendations of Cancer Care Ontario's Colonoscopy Standards Expert Panel, which was convened in March 2006 by the Program in Evidence-Based Care. The recommendations will form the basis of the quality assurance program for colonoscopy delivered in support of Ontario's CRC screening program.
Notes
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PubMed ID
18026582 View in PubMed
Less detail

[Check-ups of colorectal neoplasms--current practice]

https://arctichealth.org/en/permalink/ahliterature24347
Source
Ugeskr Laeger. 1992 Sep 14;154(38):2540-3
Publication Type
Article
Date
Sep-14-1992
Author
O H Momsen
H P Graversen
A. Kruse
Author Affiliation
Arhus Kommunehospital, Kirurgisk gastroenterologisk afdeling L.
Source
Ugeskr Laeger. 1992 Sep 14;154(38):2540-3
Date
Sep-14-1992
Language
Danish
Publication Type
Article
Keywords
Adenoma - diagnosis - prevention & control - surgery
Carcinoma - diagnosis - prevention & control - surgery
Colonic Neoplasms - diagnosis - prevention & control - surgery
Denmark
English Abstract
Follow-Up Studies
Humans
Questionnaires
Rectal Neoplasms - diagnosis - prevention & control - surgery
Abstract
In order to investigate the practice for control of patients with colorectal adenomata and cancer, a questionnaire investigation was carried out in 1990-1991 among 53 Danish surgical departments. The investigation revealed great differences in the control programmes offered to these patients as regards the methods, the intensity and duration. In addition, differences were present in the control pattern for adenomata in specialist departments as compared with the remaining departments where there was a tendency to very frequent but, on the other hand, brief control. On the basis of these results, it is considered necessary that a reference programme should be prepared on this subject.
PubMed ID
1413180 View in PubMed
Less detail

Clinical and Molecular Characteristics of Post-Colonoscopy Colorectal Cancer: A Population-based Study.

https://arctichealth.org/en/permalink/ahliterature283032
Source
Gastroenterology. 2016 Nov;151(5):870-878.e3
Publication Type
Article
Date
Nov-2016
Author
Elena M Stoffel
Rune Erichsen
Trine Frøslev
Lars Pedersen
Mogens Vyberg
Erika Koeppe
Seth D Crockett
Stanley R Hamilton
Henrik T Sørensen
John A Baron
Source
Gastroenterology. 2016 Nov;151(5):870-878.e3
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - diagnosis - epidemiology - genetics - pathology
Adenoma - diagnosis - epidemiology - genetics - pathology
Adult
Aged
Aged, 80 and over
Colonoscopy
Colorectal Neoplasms - diagnosis - epidemiology - genetics - pathology
Cross-Sectional Studies
DNA Mismatch Repair
DNA Repair-Deficiency Disorders - diagnosis - epidemiology
Denmark - epidemiology
Female
Humans
Incidence
Logistic Models
Male
Middle Aged
Registries
Time Factors
Abstract
Colonoscopy provides incomplete protection from colorectal cancer (CRC), but determinants of post-colonoscopy CRC are not well understood. We compared clinical features and molecular characteristics of CRCs diagnosed at different time intervals after a previous colonoscopy.
We performed a population-based, cross-sectional study of incident CRC cases in Denmark (2007-2011), categorized as post-colonoscopy or detected during diagnostic colonoscopy (in patients with no prior colonoscopy). We compared prevalence of proximal location and DNA mismatch repair deficiency (dMMR) in CRC tumors, relative to time since previous colonoscopy, using logistic regression and cubic splines to assess temporal variation.
Of 10,365 incident CRCs, 725 occurred after colonoscopy examinations (7.0%). These were more often located in the proximal colon (odds ratio [OR], 2.34; 95% confidence interval [CI], 1.90-2.89) and were more likely to have dMMR (OR, 1.26; 95% CI, 1.00-1.59), but were less likely to be metastatic at presentation (OR, 0.65; 95% CI, 0.48-0.89) compared with CRCs diagnosed in patients with no prior colonoscopy. The highest proportions of proximal and/or dMMR tumors were observed in CRCs diagnosed 3-6 years after colonoscopy, but these features were still more frequent among cancers diagnosed up to 10 years after colonoscopy. The relative excess of dMMR tumors was most pronounced in distal cancers. In an analysis of 85 cases detected after colonoscopy, we found BRAF mutations in 23% of tumors and that 7% of cases had features of Lynch syndrome. Colonoscopy exams were incomplete in a higher proportion of cases diagnosed within
Notes
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Comment In: Transl Gastroenterol Hepatol. 2017 Feb 15;2:928275741
PubMed ID
27443823 View in PubMed
Less detail

Colonoscopic screening examination of relatives of patients with colorectal cancer. I. A comparison with an endoscopically screened normal population.

https://arctichealth.org/en/permalink/ahliterature24396
Source
Scand J Gastroenterol. 1992 Aug;27(8):661-6
Publication Type
Article
Date
Aug-1992
Author
J. Sauar
T. Hausken
G. Hoff
A. Bjørkheim
A. Foerster
P. Mowinckel
Author Affiliation
Dept. of Medicine, Telemark Central Hospital, Skien, Norway.
Source
Scand J Gastroenterol. 1992 Aug;27(8):661-6
Date
Aug-1992
Language
English
Publication Type
Article
Keywords
Adenoma - diagnosis - epidemiology
Adult
Aged
Carcinoma - epidemiology - prevention & control
Colonic Polyps - epidemiology - prevention & control
Colonoscopy
Colorectal Neoplasms - epidemiology - genetics - prevention & control
Comparative Study
Female
Follow-Up Studies
Humans
Male
Middle Aged
Norway - epidemiology
Prevalence
Risk factors
Abstract
First-degree relatives (n = 206) of patients operated on for colorectal cancer (CRC) (n = 181) were offered a colonoscopic screening examination; 169 relatives (82%) attended. The findings were compared with those in a normal population sample with no CRC in first-degree relatives (n = 308), aged 50-59 years, who had been screened by means of flexible sigmoidoscopy. Three carcinomas and 176 polyps were found in 56 of 95 male relatives (57%) and 34 of 74 female relatives (46%). The adenoma prevalence rate was 37 (39%) and 26 (35%) for male and female relatives, respectively. In the 50- to 59-year age group, the adenoma prevalence rates for both sexes collectively and for women separately were significantly higher among relatives than among the population without CRC relatives. Hyperplastic polyps were larger, whereas adenomas were similar in size among relatives compared with the normal population. Colonoscopy may be a suitable method of choice for screening first-degree relatives of patients with CRC.
PubMed ID
1439548 View in PubMed
Less detail

Colonoscopy findings in high-risk individuals compared to an average-risk control population.

https://arctichealth.org/en/permalink/ahliterature271344
Source
Scand J Gastroenterol. 2015 Jul;50(7):866-74
Publication Type
Article
Date
Jul-2015
Author
Anna Forsberg
Lars Kjellström
Anna Andreasson
Edgar Jaramillo
Carlos A Rubio
Erik Björck
Lars Agréus
Nicholas J Talley
Annika Lindblom
Source
Scand J Gastroenterol. 2015 Jul;50(7):866-74
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Adenoma - diagnosis - pathology
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Case-Control Studies
Colonoscopy - methods
Colorectal Neoplasms - diagnosis - epidemiology - pathology
Colorectal Neoplasms, Hereditary Nonpolyposis - diagnosis - pathology
Female
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Mass Screening
Middle Aged
Polyps - pathology
Risk factors
Sex Factors
Sweden
Young Adult
Abstract
There is clear evidence of reduced morbidity and mortality from regular colonoscopy programs in patients with Lynch syndrome (LS). Today, also individuals with empirically increased risks of colorectal cancer (CRC) are offered colonoscopic surveillance. The aim was to compare the findings at the first screening colonoscopy in LS carriers, and individuals with an increased risk of bowel cancer due to family history of CRC with a control population.
Altogether 1397 individuals with an increased risk for CRC were divided in four risk groups: one with LS carriers and three groups with individuals with different family history of CRC. The findings were compared between the different risk groups and a control group consisting of 745 individuals from a control population who took part in a population-based colonoscopy study.
In LS, 30% of the individuals had adenomas and 10% advanced adenomas. The corresponding figures in the other risk groups were 14-24% and 4-7%, compared with 10% and 3% in the control group. The relative risk of having adenomas and advanced adenomas was, compared to controls, significantly higher for all risk groups except the group with the lowest risk. Age was a strong predictor for adenomas and advanced adenomas in both risk individuals and controls.
Individuals with a family history of CRC have a high prevalence and cumulative risk of adenomas and advanced adenomas, and screening is motivated also in this risk group.
PubMed ID
25762374 View in PubMed
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