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Management of Rectal Cancer in a Young Woman
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Although there is a trend for genetic microsatellite instability as a cause for the young-onset rectal cancer patients, there is currently no conclusive evidence of an obvious etiology. Current colorectal cancer screening guidelines target people above the age of 50 years. However, given the alarming trend in incidence of rectal cancer in the young, there is a suggestion to bring down the age of screening to commence at 40 years of age [5].
Issues in screening for cancer
Published in Norman J. Temple, Andrew Thompson, Excessive Medical Spending, 2018
The benefits of colorectal cancer screening with effective methods are also around one in 1000. The major disadvantage is the high induced demand for colonoscopy. This may influence availability for patients with complaints. Again, it is important to note that timely diagnosis is most important in cancer that shows clinically detectable symptoms. It is close to medical negligence to consider colorectal cancer screening in a country that has apparent capacity problems and waiting lists for colonoscopy. Screening will increase capacity problems, waiting lists, and treatment delays for real cancer patients.
The Conway-Maxwell-Poisson distribution and capture-recapture count data
Published in Dankmar Böhning, Peter G.M. van der Heijden, John Bunge, Capture-Recapture Methods for the Social and Medical Sciences, 2017
Antonello Maruotti, Orasa Anan
Colorectal cancer is one of the most common cancer types. Colonoscopy is considered an effective tool for colorectal cancer screening and studies have shown that colonoscopy is associated with a reduction of Colorectal cancer incidence and mortality. In 1990, the Arizona Cancer Center initiated a multicenter trial to determine whether wheat bran fiber can prevent the recurrence of colorectal adenomatous polyps (Alberts et al. [3]). Subjects with a previous history of colorectal adenomatous polyps were recruited and randomly assigned to one of two treatment groups, low fiber and high fiber. From medical research experience it is well recognized that diagnosing adenomatous polyps can be subjected to undercount due to misclassification at colonoscopy. In the following, we evaluate the recurrence of colorectal adenomatous polyps. Subjects with previous history of colorectal adenomatous polyps are allocated to one of two treatment groups, low fiber and high fiber. For both groups the population size is known in advance: 584 for the low-fiber treatment (f0 = 285) and 722 for high-fiber treatment (f0 = 381) respectively (see Figures 3.1(c)-(d)). We assumed that patients with a positive polyp count were diagnosed correctly, whereas it is unclear how many persons with zero polyps were false-negatively diagnosed. Thus, we approach the data as if zero counts were not observed, and we try to estimate the undercount from the nonzero frequencies.
The effectiveness of using an abdominal binder during colonoscopy: a randomized, double-blind, sham-controlled trial
Published in Scandinavian Journal of Gastroenterology, 2021
Colonoscopy is considered the primary screening test for colorectal cancer screening worldwide [1]. Researches show that by 2030, 24 million colonoscopy procedures will be required for colorectal cancer screening in the USA [2]. However, most individuals refrain from undergoing colonoscopy. One of the most important reasons for this is the pain during or after the procedure, about which the patient learns from their own experiences and their relatives’ experiences [3]. This pain directly affects the comfort of the patient and is characterized as a visceral pain, which occurs either mechanically by the colonoscopy device or as a result of air or CO2 insufflation stretching the intestinal wall. For this reason, the prolongation of the colonoscopy procedure directly adversely affects the pain and thus the comfort of the individual [4].
Values of liquid biopsy in early detection of cancer: results from meta-analysis
Published in Expert Review of Molecular Diagnostics, 2021
Sinong Jia, Li Xie, Lei Li, Ying Qian, Jie Wang, Suna Wang, Weituo Zhang, Biyun Qian
Early detection of cancer has been shown to dramatically improve patient survival rates and quality of life, as well as significantly reduce the cost and complexity of cancer treatment, especially in particular for tumors that do not have a screening test available. Most countries use guaiac fecal occult blood test (gFOBT) or fecal immunochemical test (FIT) to screen for colorectal cancer. The sensitivity and specificity of gFOBT were 61.0% and 95.1%, respectively. The sensitivity and specificity of FIT were 23.8% and 97.7%, respectively, [31,32]. In this study, a total of four studies on early detection of colorectal cancer, and the pooled sensitivity and specificity were 75% and 90%, respectively. The performance of liquid biopsy in colorectal cancer screening is satisfactory, and it may become a screening method for colorectal cancer in the future. With the NLST (National Lung Screening Trial) definition of a positive screen, sensitivity and specificity of low-dose chest CT (LDCT) were 93.1% and 76.5%, respectively [33]. In this study, a total of three studies on early detection of lung cancer, and the pooled sensitivity and specificity were 58% and 86%, respectively. Compared with LDCT, liquid biopsy has lower sensitivity and higher specificity. The sensitivity of liquid biopsy needs to be further improved.
Projecting total costs and health consequences of increasing mt-sDNA utilization for colorectal cancer screening from the payer and integrated delivery network perspectives
Published in Journal of Medical Economics, 2020
Joanne M. Hathway, Lesley-Ann Miller-Wilson, Ivar S. Jensen, Burak Ozbay, Catherine Regan, Anupam B. Jena, Milton C. Weinstein, Philip D. Parks
Colorectal cancer screening is an on-going public health challenge and opportunity. There are multiple screening options with different screening intervals and variable levels of evidence supporting cost-effectiveness, performance, risk of harm, patient preference, and benefit for the prevention and early detection of CRC. The USPSTF and ACS prioritize screening uptake and adherence over the endorsement of a particular screening modality2,8. There are no head-to-head high quality data that compare the performance, effectiveness, or patient preference for colonoscopy, fecal immunochemical tests (FIT), fecal occult blood tests (FOBT), and multitarget stool DNA (mt-sDNA, [Cologuard®]). Current CRC screening options included in guidelines can be categorically described as structural examinations (colonoscopy, CT colonography, flexible sigmoidoscopy), and stool-based tests (FIT, FOBT, mt-sDNA).