Association of Colonoscopy and Death From Colorectal Cancer

Baxter, Nancy N.; Goldwasser, Meredith A.; Paszat, Lawrence; Saskin, Refik; Urbach, David R.; Rabeneck, Linda

doi:10.7326/0003-4819-150-1-200901060-00306

Cited by 1,152 publications

(801 citation statements)

References 41 publications

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“…Our detection model also demonstrates useful detection performance for other clinical conditions that generate increases or decreases in Hgb values. Other currently available risk scores for CRC utilizing age, sex, body mass index (BMI) as well as medical history, diet, exercise, and other predictive factors have been shown to either have poor discriminatory power [33,34], require collection of patient-reported information, or focus on the estimation of individual lifetime risk of CRC, which is quite different from current risk [34]. Work is beginning on re-estimating our CRC detection model using US HMO data (KPNW).…”

Section: Discussionmentioning

confidence: 99%

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Hornbrook

Goshen²,

Choman³

et al. 2017

Dig Dis Sci

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Background Machine learning tools identify patients with blood counts indicating greater likelihood of colorectal cancer and warranting colonoscopy referral. Aims To validate a machine learning colorectal cancer detection model on a US community-based insured adult population. Methods Eligible colorectal cancer cases (439 females, 461 males) with complete blood counts before diagnosis were identified from Kaiser Permanente Northwest Region's Tumor Registry. Control patients (n = 9108) were randomly selected from KPNW's population who had no cancers, received at C1 blood count, had continuous enrollment from 180 days prior to the blood count through 24 months after the count, and were aged 40-89. For each control, one blood count was randomly selected as the pseudo-colorectal cancer diagnosis date for matching to cases, and assigned a ''calendar year'' based on the count date. For each calendar year, 18 controls were randomly selected to match the general enrollment's 10-year age groups and lengths of continuous enrollment. Prediction performance was evaluated by area under the curve, specificity, and odds ratios. Results Area under the receiver operating characteristics curve for detecting colorectal cancer was 0.80 ± 0.01. At 99% specificity, the odds ratio for association of a high-risk detection score with colorectal cancer was 34.7 (95% CI 28.9-40.4). The detection model had the highest accuracy in identifying right-sided colorectal cancers. Conclusions ColonFlag Ò identifies individuals with tenfold higher risk of undiagnosed colorectal cancer at curable stages (0/I/II), flags colorectal tumors 180-360 days prior to usual clinical diagnosis, and is more accurate at identifying right-sided (compared to left-sided) colorectal cancers.

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Section: Discussionmentioning

confidence: 99%

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Hornbrook

Goshen²,

Choman³

et al. 2017

Dig Dis Sci

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“…Second, more detailed information about variation in SC effectiveness as well as colonoscopy-associated death rates and non-fatal health outcomes, including quality of life and patient preferences, should be explored 47,48 . Third, future work should incorporate other determinants of cancer risk as well as alternate screening modalities, given evidence suggesting the benefits of flexible sigmoidoscopies in particular may be comparable to SC [49][50][51] . Fourth, our categorization of patients into the three benefit categories (higher, lower, and no expected benefit) was likely subject to some misclassification, as we were not able to account for all relevant factors.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

et al. 2011

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“…In a non-populationbased screening setting in North America, interval cancers have been associated with proximal location and molecular traits, such as CpG island methylation phenotype (CIMP) [60], that occur in most sessile serrated lesions and traditional serrated adenomas [25]. Under-detection of non-polypoid and serrated lesions may therefore play a role in study results that have not shown a protective effect of colonoscopy against CRC mortality in the right colon [61,62]. The international discussions on the significance of these lesions, during the development of the guidelines, stimulated further efforts to clarify appropriate methods of histologic reporting and clinical management [59] and led to related recommendations in the guidelines [21,25].…”

Section: Author Manuscriptmentioning

confidence: 92%

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

Karsa¹,

Patnick²,

Segnan³

et al. 2012

Endoscopy

228

169

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Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines. IntroductionAccording to recent estimates by the International Agency for Research on Cancer [1], colorectal cancer (CRC) is the most common cancer in Europe with 432 000 new cases reported annually in men and women combined. It is the second most common cause of cancer deaths in Europe with 212 000 deaths reported in 2008.Worldwide, CRC ranks third in incidence and fourth in mortality with an estimated 1.2 million cases and 0.6 million deaths annually. In the 27 Member States of the European Union (EU), CRC ranks first in incidence and second in mortality, with approximately 334000 new cases and 149000 deaths estimated in 2008.Even in those Member States in the lower range for age-standardized rates of CRC, the burden of disease is significantly greater when compared with many other HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript regions of the world (see reference [1]). CRC is therefore an important health problem across the EU.Screening can be effective in cancer control in populations with a significant burden of CRC, provided the services are of high quality [2]. The aim of CRC screening is to lower the burden of cancer in the population by discovering disease in its early, latent stages [3]. Evidence-based methods permit treatment that is more effective than if disease is diagnosed later when symptoms have occurred. Early treatment of invasive lesions, for example by endoscopic resection of early CRC, can also be less detrimental for quality of life. The endoscopic removal of pre-malignant lesions also reduces the incidence of CRC by avoiding the progression to cancer. Randomized trials in people of average risk invite...

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Association of Colonoscopy and Death From Colorectal Cancer

Abstract: In usual practice, colonoscopy is associated with fewer deaths from CRC. This association is primarily limited to deaths from cancer developing in the left side of the colon.

Cited by 1,152 publications

References 41 publications

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

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