Clinical predictors of colorectal polyps and carcinoma in a low prevalence region: Results of a colonoscopy based study

Bafandeh, Yousef; Khoshbaten, Manouchehr; Sadat, Amir Taher Eftekhar; Farhang, Sara

doi:10.3748/wjg.14.1534

Cited by 36 publications

(66 citation statements)

References 36 publications

(34 reference statements)

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“…Aanother study has indicated that the prevalence of CRC is more common in younger Iranians compared to other reports around the world (Pahlavan and Kanthan 2006;Bafandeh et al, 2008). With regards to the fact that previous studies conducted in Iran involved symptomatic subjects and in contrast , our study was conducted on a greater sample size of asymptomatic subjects; our findings are of compelling importance in that it shows an increasing trend in the occurrence of colorectal neoplasia in our population.…”

Section: Discussionmentioning

confidence: 47%

“…Moreover, according to the recent studies conducted in Iran, the prevalence of total colorectal adenoma and CRC in symptomatic patients were 11.7% and 3.6%, respectively (Bafandeh et al, 2008;Abdifard et al, 2013). Aanother study has indicated that the prevalence of CRC is more common in younger Iranians compared to other reports around the world (Pahlavan and Kanthan 2006;Bafandeh et al, 2008).…”

Section: Discussionmentioning

confidence: 95%

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Prevalence of Colorectal Polyps in a Group of Subjects at Average-risk of Colorectal Cancer Undergoing Colonoscopic Screening in Tehran, Iran between 2008 and 2013

Sohrabi¹,

Zamani²,

Ajdarkosh³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Colorectal cancer (CRC) is one of the prime causes of mortality around the globe, with a significantly rising incidence in the Middle East region in recent decades. Since detection of CRC in the early stages is an important issue, and also since to date there are no comprehensive epidemiologic studies depicting the Middle East region with special attention to the average risk group, further investigation is of significant necessity in this regard. Aim: Our aim was to investigate the prevalence of preneoplastic and neoplastic lesions of the colon in an average risk population. Materials and Methods: A total of 1,208 eligible asymptomatic, average-risk adults older than 40 years of age, referred to Firuzgar Hospotal in the years 2008-2012, were enrolled. They underwent colonoscopy screening and all polypoid lesions were removed and examined by an expert gastrointestinal pathologist. The lesions were classified by size, location, numbers and pathologic findings. Size of lesions was measured objectively by endoscopists. Results: The mean age of participants was 56.5 ± 9.59 and 51.6% were male. The overall polyp detection rate was 199/1208 (16.5 %), 26 subjects having non-neoplastic polyps, including hyperplastic lesions, and 173/1208 (14.3%) having neoplastic polyps, of which 26 (2.15%) were advanced neoplasms .The prevalence of colorectal neoplasia was more common among the 50-59 age group. Advanced adenoma was more frequent among the 60-69 age group. The majority of adenomas were detected in the distal colon, but a quarter of advanced adenomas were found in the proximal colon; advance age and male gender was associated with the presence of adenoma. Conclusions: It seems that CRC screening among average-risk population might be recommended in countries such as Iran. However, sigmioidoscopy alone would miss many colorectal adenomas. Furthermore, the 50-59 age group could be considered as an appropriate target population for this purpose in Iran.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 95%

Prevalence of Colorectal Polyps in a Group of Subjects at Average-risk of Colorectal Cancer Undergoing Colonoscopic Screening in Tehran, Iran between 2008 and 2013

Sohrabi¹,

Zamani²,

Ajdarkosh³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…Unexplained anemia is a major predictor of CRC in the elderly [11] and, together with hemorrhoids, is the most common cause for delay in CRC diagnosis [11][12][13][14]. Blood loss is present in 60% of CRC cases, and a daily loss of as little as 3 mL in the stool can cause iron deficiency anemia [15].…”

mentioning

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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“…Firstly, when comparing sensitivities of FIT for screen-relevant neoplasia in patients from the present study population who could be considered to have a low risk for colonic neoplasia to those that would be at higher risk, only minor differences in sensitivity were found (29,30). Secondly, spectrum bias could also be explained by a different tumor stage distribution in the referral population compared with those in a screening population.…”

Section: Discussionmentioning

confidence: 80%

Higher Fecal Immunochemical Test Cutoff Levels: Lower Positivity Rates but Still Acceptable Detection Rates for Early-Stage Colorectal Cancers

Droste

Oort

Hulst

et al. 2011

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Adjusting the threshold for positivity of quantitative fecal immunochemical tests (FIT) allows for controlling the number of follow-up colonoscopies in a screening program. However, it is unknown to what extent higher cutoff levels affect detection rates of screen-relevant neoplasia. This study aimed to assess the effect of higher cutoff levels of a quantitative FIT on test positivity rate and detection rate of early-stage colorectal cancers (CRC).Methods: Subjects above 40 years old scheduled for colonoscopy in 5 hospitals were asked to sample a single FIT (OC sensor) before colonoscopy. Screen-relevant neoplasia were defined as advanced adenoma or early-stage cancer (stage I and II). Positivity rate, sensitivity, and specificity were evaluated at increasing cutoff levels of 50 to 200 ng/mL.Results: In 2,145 individuals who underwent total colonoscopy, 79 patients were diagnosed with CRC, 38 of which were with early-stage disease. Advanced adenomas were found in 236 patients. When varying cutoff levels from !50 to !200 ng/mL, positivity rates ranged from 16.5% to 10.2%. With increasing cutoff levels, sensitivity for early-stage CRCs and for screen-relevant neoplasia ranged from 84.2% to 78.9% and 47.1% to 37.2%, respectively.Conclusions: Higher FIT cutoff levels substantially decrease test positivity rates with only limited effects on detection rates of early-stage CRCs. However, spectrum bias resulting in higher estimates of sensitivity than would be expected in a screening population may be present.Impact: Higher cutoff levels can reduce strain on colonoscopy capacity with only a modest decrease in sensitivity for curable cancers. Cancer Epidemiol Biomarkers Prev; 20(2); 272-80. Ó2010 AACR.

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Clinical predictors of colorectal polyps and carcinoma in a low prevalence region: Results of a colonoscopy based study

Cited by 36 publications

References 36 publications

Prevalence of Colorectal Polyps in a Group of Subjects at Average-risk of Colorectal Cancer Undergoing Colonoscopic Screening in Tehran, Iran between 2008 and 2013

Prevalence of Colorectal Polyps in a Group of Subjects at Average-risk of Colorectal Cancer Undergoing Colonoscopic Screening in Tehran, Iran between 2008 and 2013

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

Higher Fecal Immunochemical Test Cutoff Levels: Lower Positivity Rates but Still Acceptable Detection Rates for Early-Stage Colorectal Cancers

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