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Plant-Based Phytochemicals in the Prevention of Colorectal Cancer
Published in Megh R. Goyal, Preeti Birwal, Durgesh Nandini Chauhan, Herbs, Spices, and Medicinal Plants for Human Gastrointestinal Disorders, 2023
Colorectal cancer is screened for in the United States via an annual fecal occult blood test, fecal immunochemical test (FIT), and FIT-DNA (multitarget stool DNA test); with colonoscopy starting at the age of 45 and repeated every 5 years if no positive findings occur; or with flexible sigmoidoscopy every 5 years. If colorectal cancer is found through symptoms, typically the tumor is in a more advanced stage. The staging of colorectal cancer provides the physician with a framework for a treatment plan.
Colorectal Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Jennie Grainger, Samson Tou, Steve Schlichtemeier, William Speake, Fung Joon Foo, Frank McDermott
FIT stands for fecal immunochemical test. It is a type of FOB test, which uses antibodies that specifically recognise human haemoglobin. It utilises immunochromatography and uses antibodies that are specific for human haemoglobin. The test result is not influenced by non-human blood in feces. It will only react with the intact haemoglobin molecule, therefore should only identify pathology within the colon. This will reduce the number of false-positive results currently seen with the standard FOBT. The level of a ‘positive’ test, thus determining the need for a colonoscopy has yet to be finalised.In Scotland, FIT replaced guaiac-based FOB test for bowel screening in November 2017. FIT was rolled out in England and Wales as a replacement for FOBT in 2019.
Colon cancer diagnosed in patients with non-specific symptoms – comparisons between diagnostic paradigms
Published in Acta Oncologica, 2023
Christina Sadolin Damhus, Volkert Siersma, Anna Rubach Birkmose, Henrik Støvring, Susanne Oksbjerg Dalton, John Brandt Brodersen
A strength of this study is the large dataset from high-quality validated Danish registers in which we were able to link information about cancer stage at diagnosis and diagnostic activity. No other study has examined the stage at diagnosis while investigating different paradigms of initial cancer work-up in Denmark. When designing this study, we knew we would include people with a CT scan that was likely to be unrelated to cancer work-up, thus, strength is the presentation of ORs under a range of different assumptions. Due to organisational variations of the NSSC-CPP in Denmark, patients having their initial diagnostic work-up in general practice are not labelled – NSSC-CPP, but those starting their diagnostic workup in a diagnostic unit at the hospital are. Therefore, to identify these two populations and later compare them, we cannot use the label – NSSC-CPP. Regardless of organisational structure most of the patients with non-specific symptoms of cancer are having a CT scan as part of the initial diagnostic work-up. Therefore, CT scan was used as a marker to identify the population of interest for this study. Still, some patients with non-specific symptoms do not have a CT scan but might have an alternative test such as a fecal immunochemical test (FIT), however, not included in the analysis. However, as long as no sufficient registration of the GP-initiated diagnostic work-up exists, we suggest the CT scan as the best marker for initiation of diagnostic work-up as it is the most often used test within the NSSC-CPP setting and recommend by guidelines [10].
Testing Enhanced Active Choice to Optimize Acceptance and Participation in a Population-Based Colorectal Cancer Screening Program in Malta
Published in Behavioral Medicine, 2022
Sandro T. Stoffel, Mariella Bombagi, Robert S. Kerrison, Christian von Wagner, Benedikt Herrmann
Colorectal cancer (CRC) is the second leading cause of cancer death in Malta. Mortality from the disease has declined in recent years, due to the implementation of effective methods for prevention, early detection, and treatment.1,2 Free routine screening, for example, was introduced in 2012, with all residents aged between 60 and 64 years being offered a “one-off” fecal immunochemical test (FIT).3 The Maltese Colorectal Cancer Screening Programme (CRSP) consists of two stages: a preliminary stage, in which all individuals eligible to participate in the program were sent a pre-invitation letter though the mail, and a second stage, where individuals who responded to the first stage to “opt in” were sent a free FIT kit and pre-addressed return envelope.4
Cost-effectiveness and budget impact analyses of colorectal cancer screenings in a low- and middle-income country: example from Thailand
Published in Journal of Medical Economics, 2019
Pochamana Phisalprapa, Siripen Supakankunti, Nathorn Chaiyakunapruk
Several screening modalities, such as fecal immunochemical test (FIT) and colonoscopy, have been available with clear effectiveness on the reduction of CRC incidence and its associated mortality11–13. The US Preventive Services Task Force (USPSTF) 2016 recommendation concludes with high certainty that screening for CRC in average-risk, asymptomatic adults aged 50 to 75 years is substantially beneficial because CRC is most frequently diagnosed among adults aged 65 to 74 years and the median age of CRC death is 68 years14. FIT is a noninvasive intervention15,16 with high sensitivity for CRC and colorectal adenomas detection17,18. Patients with positive FIT tests require colonoscopy for confirmative diagnosis16,19. A CRC screening guideline recommends colonoscopy for higher adenomas and cancer detection rates, as compared to FIT20,21. However, the colonoscopy requires bowel preparation and is more invasive and costly16.