No abstract

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States and the third most common cancer in men and the second most common cancer among women. Early detection of localized adenocarcinoma and adenomatous polyps helps reduce the mortality related to colon cancer. According to the American Gastroenterological Association, colonoscopy (CSPY) is the gold standard in screening for CRC. To improve the results of screening, the CSPY preparation (prep) needs to be optimal. This study was undertaken to determine whether a supplemental standardized educational video on bowel preparation in the viewer's native language would improve bowel preparation at the time of CSPY. After institutional review board approval, the records of adult patients who presented to the gastroenterology clinic were reviewed. Patients who underwent a CSPY were assigned according to whether they watched a supplemental educational video on CSPY bowel preparation in their native language. This video reflects the same information provided in written and verbal form at the time of CSPY scheduling. Bowel prep was rated by the endoscopist using the Boston Bowel Preparation Scale (BBPS) and quantifies the adequacy of the preprocedure bowel prep. Participant characteristics and BBPS scores were statistically assessed for significant differences. We identified a total of 186 patients, 91 in March 2015 (pre–video intervention) and 95 in March 2016 (post–video intervention). Mean BBPS score was 7.9 and 8.54 for the March 2015 and 2016 group, respectively (p value of .0039). Although there was no statistical difference between the 2 groups with concern to gender and age, the racial makeup and BBPS score were statistically different. Multivariate analysis was performed. There was no interaction between gender or race and year effect to account for any difference in that factors' performance. Thus, it can be implied that there is not a consistent race effect but there is a consistent gender effect with females having higher success rates, regardless of video intervention (p value of .003). After controlling for both gender and race, the year effect is modestly significant (p value of .025), with the post–video subjects having higher prep success rates. A supplemental educational video incorporated into precolonoscopy teaching may provide a standardized method of effectively conveying simple bowel prep instructions in an efficient manner. This study demonstrated that using such a video produced significant results in improving the quality of bowel preparation.

Background The rate of change in the incidence of colorectal cancer (CRC) among persons younger than 50 years in the United States appears to vary by demographics, tumor location, and geography. This study analyzed data from all 50 states to examine recent changes in the incidence of CRC among persons younger than 50 years and to identify key subgroups with disproportionate risk. Methods Annual incidence rates for CRC, colon cancer, and rectal cancer in persons aged 20 to 49 years were extracted from the US Cancer Statistics for the period 2001‐2017. Secular trends were examined overall and by age group, sex, race/ethnicity, stage, and state. Joinpoint regression was used to compute annual percent changes and average annual percent changes (AAPCs) as well as corresponding 95% confidence intervals (95% CIs). Results The incidence of CRC increased by 1.27% (95% CI, 0.95%‐1.60%) annually from 2001 to 2012 and by 3.00% (95% CI, 2.06%‐3.95%) annually from 2012 to 2017. AAPCs for the period 2001‐2017 were higher among persons aged 20 to 24 years (AAPC, 6.62%; 95% CI, 3.86%‐9.45%) in comparison with other age groups and higher among non‐Hispanic Whites (AAPC, 2.38%; 95% CI, 1.98%‐2.79%) in comparison with other racial/ethnic groups. In 2001‐2002, only 1 state had an age‐standardized incidence rate > 13.0 per 100,000, but this number increased to 32 states by 2016‐2017. Conclusions CRC rates among US adults aged 20 to 49 years increased from 2001 to 2017, with the fastest increases observed from 2012 to 2017. Increases were observed among the youngest age groups, among non‐Hispanic Whites, and in states in the West, Midwest, and Rocky Mountain regions. Increasing rates across all tumor stages suggest a real increase in CRC incidence.