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Screening colonoscopy interval

Amy L Cisyk, Zoann Nugent, Robert H Wightman, Harminder Singh, Kirk J McManus
There are a substantial portion of colorectal cancers (CRCs), termed interval CRCs (I-CRCs), that are diagnosed shortly after a negative colonoscopy (i.e., no detectable polyps or CRC) and before recommended follow-up screening. The underlying cause(s) accounting for I-CRCs remain poorly understood, but may involve aberrant biology that drives genome instability. Genetic defects inducing genome instability are pathogenic events that lead to the development and progression of traditional sporadic (Sp-) CRCs...
August 15, 2018: Neoplasia: An International Journal for Oncology Research
Eugenia N Uche-Anya, Nicole DeCuir, Benjamin Lebwohl
BACKGROUND: Colonoscopy is effective for colorectal cancer (CRC) prevention, yet patients may develop CRC despite adhering to screening/surveillance intervals. There are limited data on predictive factors associated with these postcolonoscopy CRCs (PCCRCs). We aimed to measure PCCRC rates and identify risk factors for PCCRC. METHODS: We performed a case-control study, comparing patients with PCCRCs to spontaneous CRCs diagnosed during a 12.5-year period at an academic medical center...
August 16, 2018: Journal of Clinical Gastroenterology
Muhammad Yasir Khan, Ahmed Dirweesh, Waqas Javed Siddiqui
Background: Colorectal cancer (CRC) is a leading cause of death worldwide. Polyp detection rate (PDR) and adenoma detection rate (ADR) are key focus in endoscopic research for CRC screening and prevention. Use of anti-spasmodic agents during colonoscopy to help identify adenomas and polyps has remained a controversial topic. Hyoscine butyl bromide (HBB) is the most commonly used anti-spasmodic agent in patients undergoing colonoscopy. Some randomized controlled trials (RCTs) have questioned the clinical efficacy and safety of routine use of HBB for polyp and adenoma detection rates...
August 2018: Gastroenterology Research
Lynn F Butterly, Marion R Nadel, Joseph C Anderson, Christina M Robinson, Julia E Weiss, David Lieberman, Jean A Shapiro
BACKGROUND AND AIMS: National guidelines for colonoscopy screening and surveillance assume adequate bowel preparation. We used New Hampshire Colonoscopy Registry (NHCR) data to investigate the influence of bowel preparation quality on endoscopist recommendations for follow-up intervals in average-risk patients following normal screening colonoscopies. METHODS: The analysis included 9170 normal screening colonoscopies performed on average risk individuals aged 50 and above between February 2005 and September 2013...
August 13, 2018: Journal of Clinical Gastroenterology
Nam Hee Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn
BACKGROUND: Obesity and metabolic syndrome are risk factors for colorectal neoplasia (CRN). However, the association between metabolically healthy obese (MHO) or metabolically unhealthy non-obese (MUNO) status and the risk of CRN remains unclear. AIMS: We aimed to elucidate the association between MHO or MUNO status and the risk of CRN. METHODS: A total of 139,023 asymptomatic subjects who underwent a primary screening colonoscopy were categorized into 4 groups according to obesity and metabolic status: metabolically healthy non-obese (MHNO), MHO, MUNO, and metabolically unhealthy obese (MUO)...
August 9, 2018: Digestive Diseases and Sciences
Stefanos Karamaroudis, Aliki Stamou, Stamatia C Vorri, Paraskevas Gkolfakis, Vasilios Papadopoulos, Georgios Tziatzios, Aikaterini Karagouni, Panagiota Katsouli, George D Dimitriadis, Konstantinos Triantafyllou
Background: We monitor colonoscopy service quality biannually, by measuring sedation administration, colonoscopy completion, adenoma detection and early complications rates (CR). We herein present our audit results for the years 2013 and 2015. Methods: In our endoscopy facility, five rotating senior gastroenterologists perform colonoscopies, on a daily basis. We measured the quality indicators in three cohorts: A, intention for total colonoscopy cases; B, cohort A excluding bowel obstruction cases; C, colorectal cancer (CRC) screening cases...
July 2018: Annals of Translational Medicine
Jung Yoon Kim, Tae Jun Kim, Sun-Young Baek, Soohyun Ahn, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim
OBJECTIVES: Individuals with advanced adenomas or three or more adenomas have a higher risk of metachronous advanced neoplasia (AN) and are recommended to undergo surveillance colonoscopy at shorter intervals. However, it is questionable whether patients with multiple (three or more) non-advanced diminutive adenomas should be considered as high-risk. METHODS: We analyzed 5482 patients diagnosed with one or more adenomas during their first colonoscopy screening and who underwent a follow-up colonoscopy...
August 3, 2018: American Journal of Gastroenterology
Stacy B Menees, H Myra Kim, Grace H Elta, Sheryl Korsnes, Philip Schoenfeld
Goal: To prospectively assess physician recommendations for repeat colonoscopy in an average-risk screening cohort. Background: Endoscopists' adherence to colorectal cancer screening and surveillance guidelines for repeat colonoscopy have not been well characterized. Furthermore, little is known about patient and colonoscopy factors that are associated with endoscopists' nonadherence to guideline recommendation. Study: This is a prospective cohort of average-risk patients undergoing colonoscopy for colorectal cancer screening between August 2011 and January 2013...
2018: Gastroenterology Research and Practice
Katharina Zimmermann-Fraedrich, Stefan Groth, Susanne Sehner, Stefan Schubert, Jens Aschenbeck, Michael Mayr, Alireza Aminalai, Andreas Schröder, Jens-Peter Bruhn, Michael Bläker, Thomas Rösch, Guido Schachschal
BACKGROUND:  Previous studies have shown that multiple colonoscope features have to be changed before an improvement in adenoma detection rate (ADR) becomes obvious, such as with changing from one instrument generation to the next but one. We wanted to evaluate whether such an effect can also be observed in a private-practice screening setting. METHODS:  In a randomized study, we compared the latest generation colonoscopes from one company (Olympus Exera III, 190) with the next to last one (Olympus 165), including only patients presenting for screening colonoscopy...
July 23, 2018: Endoscopy
Theodore R Levin, Douglas A Corley, Christopher D Jensen, Joanne E Schottinger, Virginia P Quinn, Ann G Zauber, Jeffrey K Lee, Wei K Zhao, Natalia Udaltsova, Nirupa R Ghai, Alexander T Lee, Charles P Quesenberry, Bruce H Fireman, Chyke A Doubeni
BACKGROUND & AIMS: Little information is available on the effectiveness of organized colorectal cancer (CRC) screening on screening uptake, incidence, and mortality in community-based populations. METHODS: We contrasted screening rates, age-adjusted annual CRC incidence, and incidence-based mortality rates before (baseline year 2000) and after (through 2015) implementation of organized screening outreach, from 2007 through 2008 (primarily annual fecal immunochemical testing and colonoscopy), in a large, community-based population...
July 19, 2018: Gastroenterology
Dora Colussi, Margherita Fabbri, Rocco Maurizio Zagari, Amedeo Montale, Franco Bazzoli, Luigi Ricciardiello
Background: Many countries have adopted the fecal immunochemical test (FIT) as the primary colorectal cancer (CRC) screening tool; however, its accuracy is limited. Epidemiological studies have shown that obesity and type 2 diabetes increase risk for the disease. Objective: The objective of this article is to evaluate the association of colorectal polyps and cancer with comorbidities and lifestyle factors in a population that is part of a FIT-based CRC screening program...
July 2018: United European Gastroenterology Journal
Alain Sánchez-González, Begonya García-Zapirain, Daniel Sierra-Sosa, Adel Elmaghraby
The increasing use of colorectal cancer screening programs has contributed to the growing number of colonoscopies performed by health centers. Hence, in recent years there has been a tendency to develop medical diagnosis support tools in order to assist specialists. This research has designed an automatized polyp detection system that allows a reduction in the rate of missed polyps that can lead to interval cancer; one of the main risks existing in colonoscopy. A characterization has therefore been made of the shape, color and curvature of edges and their regions, enabling the segmentation of polyps present in colonoscopy images...
July 6, 2018: Computers in Biology and Medicine
Alison T Brenner, Jewels Rhode, Jeff Y Yang, Dana Baker, Rebecca Drechsel, Marcus Plescia, Daniel S Reuland, Tom Wroth, Stephanie B Wheeler
BACKGROUND: Colorectal cancer (CRC) screening is effective but underused. Screening rates are lower among Medicaid beneficiaries versus other insured populations. No studies have examined mailed fecal immunochemical testing (FIT)-based outreach programs for Medicaid beneficiaries. METHODS: In a patient-level randomized controlled trial, a mailed CRC screening reminder plus FIT, sent from an urban health department to Medicaid beneficiaries, was compared with the same reminder without FIT...
July 13, 2018: Cancer
Gaius Julian Augustus, Denise J Roe, Elizabeth T Jacobs, Peter Lance, Nathan A Ellis
BACKGROUND: Screening in the average risk population for colorectal cancer (CRC) is expected to reduce the incidence of distant (i.e., metastatic) CRCs at least as much as less advanced CRCs. Indeed, since 2000, during which time colonoscopy became widely used as a screening tool, the overall incidence of CRC has been reduced by 29%. OBJECTIVE: The purpose of the current study was to determine whether the reduction of incidence rates is the same for all stages of disease...
2018: PloS One
Lorenzo Fuccio, Leonardo Frazzoni, Cesare Hassan, Marina La Marca, Valentina Paci, Veronica Smania, Nicola De Bortoli, Franco Bazzoli, Alessandro Repici, Douglas Rex, Sergio Cadoni
BACKGROUND AND AIMS: Water-aided colonoscopy techniques (water immersion, WI; water exchange, WE) have shown different results regarding adenoma detection rate (ADR). We determined the impact of WI and WE on ADR and other procedural outcomes versus gas (air, AI; carbon dioxide, CO2 ) insufflation colonoscopy. METHODS: Systematic search of multiple databases for randomized controlled trials comparing WI and/or WE with AI and/or CO2 and reporting ADR. A network meta-analysis with mixed comparisons was performed...
July 5, 2018: Gastrointestinal Endoscopy
Gregor Urban, Priyam Tripathi, Talal Alkayali, Mohit Mittal, Farid Jalali, William Karnes, Pierre Baldi
BACKGROUND & AIMS: The benefit of colonoscopy for colorectal cancer prevention depends on the adenoma detection rate (ADR). The ADR should reflect adenoma prevalence rate, estimated to be greater than 50% among the screening-age population. Yet the rate of adenoma detection by colonoscopists varies from 7% to 53%. It is estimated that every 1% increase in ADR reduces the risk of interval colorectal cancers by 3-6%. New strategies are needed to increase the ADR during colonoscopy. We tested the ability of computer-assisted image analysis, with convolutional neural networks (a deep learning model for image analysis), to improve polyp detection, a surrogate of ADR...
June 18, 2018: Gastroenterology
Anu E Obaro, David N Burling, Andrew A Plumb
Colorectal cancer (CRC) incidence and mortality can be significantly reduced by population screening. Several different screening methods are currently in use, and this review focuses specifically on the imaging technique computed tomographic colonography (CTC). The challenges and logistics of CTC screening, as well as the importance of test accuracy, uptake, quality assurance and cost-effectiveness will be discussed. With comparable advanced adenoma detection rates to colonoscopy (the most commonly used whole-colon investigation), CTC is a less-invasive alternative, requiring less laxative, and with the potential benefit that it permits assessment of extra colonic structures...
July 5, 2018: British Journal of Radiology
Thu Pham, Aung Bajaj, Lorela Berberi, Chengcheng Hu, Sasha Taleban
Background/Aims: To determine the accuracy of identifying ≥6-mm adenomatous polyps during colonoscopy and define its impact on subsequent interval screening. Methods: We conducted a retrospective study of patients who underwent colonoscopies at Banner University Medical Center, Tucson from 2011 to 2015. All patients with ≥6-mm adenomatous polyps based on their colonoscopy report were included. Adenomatous polyps were excluded if they did not meet the criteria...
June 21, 2018: Clinical Endoscopy
Jack W O'Sullivan, Tim Muntinga, Sam Grigg, John P A Ioannidis
OBJECTIVE: To provide an overview of the evidence on prevalence and outcomes of incidental imaging findings. DESIGN: Umbrella review of systematic reviews. DATA SOURCES: Searches of MEDLINE, EMBASE up to August 2017; screening of references in included papers. ELIGIBILITY CRITERIA: Criteria included systematic reviews and meta-analyses of observational studies that gave a prevalence of incidental abnormalities ("incidentalomas")...
June 18, 2018: BMJ: British Medical Journal
Hui Jia, Malcolm Koo, Yu-Hsi Hsieh, Chih-Wei Tseng, Chi-Tan Hu, Linhui Zhang, Tao Dong, Yanglin Pan, Felix W Leung
GOALS: To assess the factors associated with adenoma detection in propofol-sedated patients. BACKGROUNDS: Low adenoma detection rate (ADR) are linked to increased risk of interval cancer and related deaths. Compared with air insufflation (AI) colonoscopy, the method of water exchange (WE) significantly decreased insertion pain and increased ADR in unsedated patients. Deep sedation with propofol has been increasingly used in colonoscopy. One report suggested that WE significantly increased ADR in propofol-sedated patients, but the factors associated with adenoma detection were not analyzed...
June 15, 2018: Journal of Clinical Gastroenterology
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