Colonoscopy and Sigmoidoscopy Use among the Average-Risk Population for Colorectal Cancer: A Systematic Review and Trend Analysis

Cardoso, Rafael; Niedermaier, Tobias; Chen, Chen; Hoffmeister, Michael; Brenner, Hermann

doi:10.1158/1940-6207.capr-19-0202

Cited by 25 publications

(39 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A major strength is that all countries had to follow detailed rules and recommendations for data collection in order to ensure high comparability levels and to use nationally representative probability samples [60]. Furthermore, to our knowledge, no international comparison on the use of faecal tests and colonoscopy has been carried out across all EU countries by the type of CRC screening and using nationwide population-based data [61]. The utilisation rates reported in this study will be of great importance when it comes to analysing and comparing the potential effects of screening on CRC incidence and mortality in the EU countries.…”

Section: Strengths and Weaknesses Of The Studymentioning

confidence: 99%

Utilisation of Colorectal Cancer Screening Tests in European Countries by Type of Screening Offer: Results from the European Health Interview Survey

Cardoso

Guo

Heisser

et al. 2020

Cancers

Self Cite

View full text Add to dashboard Cite

In the past two decades, an extensive rollout of colorectal cancer (CRC) screening programmes has been initiated in European countries with a large heterogeneity of screening offers. Using data from a population-based cross-sectional survey conducted between 2013 and 2016 in all European Union countries, we analysed the utilisation of faecal tests and colonoscopy among people aged 50–74 years and the factors associated with uptake by type of screening offer. We observed the highest utilisation of either test for countries with fully rolled out organised programmes with faecal tests (ranging from 29.7% in Croatia to 66.7% in the UK) and countries offering both faecal tests and colonoscopy (from 22.7% in Greece to 70.9% in Germany). Utilisation was very low for countries with no programme (from 6.3% in Romania to 30.5% in Norway). Younger age (50–54 years), longer time since last consultation with a doctor and a lifestyle score associated with increased CRC risk were significantly associated with lower test use, a pattern observed across all types of screening offers. Our results suggest that more countries should implement organised programmes with faecal immunochemical tests, in combination with alternative endoscopy offers where resources allow. Furthermore, there is a large potential for increasing screening use in Europe by better reaching the younger eligible individuals, those who have not been to the doctor recently and those at increased risk for CRC.

show abstract

Section: Strengths and Weaknesses Of The Studymentioning

confidence: 99%

Utilisation of Colorectal Cancer Screening Tests in European Countries by Type of Screening Offer: Results from the European Health Interview Survey

Cardoso

Guo

Heisser

et al. 2020

Cancers

Self Cite

View full text Add to dashboard Cite

show abstract

“…The PRS has been proposed to improve risk prediction models for risk-adapted, personalized starting ages for CRC screening, which is an application among people with no history of colonoscopy ( 13 , 19 ). For these people, the predictive performance of PRS derived from populations without previous colonoscopy would be most relevant.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, we hypothesize that a similar difference in PRS performance according to history of colonoscopy might also apply to PRS derived from other ethnic groups. Our results are based on data from Germany where prevalence of having had a screening colonoscopy is higher than in most other countries except the United States ( 13 ). Although similar differences in predictive ability of PRS between people with and without previous colonoscopy would be expected in other countries, the attenuation of the overall predictive ability of PRS (ie, in the entire population regardless of history of colonoscopy) by previous colonoscopy would be expected to be less pronounced in countries with lower colonoscopy uptake rates.…”

Section: Discussionmentioning

confidence: 99%

“…Evaluation of the predictive value of these PRS for CRC risk has, to a large extent, been based on studies from the United States and Germany, where colonoscopy has been widely used since the 1990s and 2000s, respectively ( 12 ), and where a substantial proportion of the older population from which the study populations were drawn has had prior colonoscopy ( 13 ). Much of the excess risk resulting from genetic predisposition is expected to lead to a more rapid progression of colorectal adenomas and higher CRC incidence ( 14 ).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Colorectal Cancer Risk by Genetic Variants in Populations With and Without Colonoscopy History

Guo

Chen

Chang‐Claude

et al. 2021

JNCI Cancer Spectrum

Self Cite

View full text Add to dashboard Cite

Background Polygenic risk scores (PRS), which are derived from results of large genome-wide association studies (GWAS), are increasingly propagated for colorectal cancer (CRC) risk stratification. The majority of studies included in the large GWAS consortia were conducted in the United States and Germany, where colonoscopy with detection and removal of polyps has been widely practiced over the last decades. We aimed to assess if and to what extent the history of colonoscopy with polypectomy may alter metrics of the predictive ability of PRS for CRC risk. Methods A PRS based on 140 single nucleotide polymorphisms was compared between 4939 CRC cases and 3797 controls of the DACHS study, a population-based case-control study conducted in Germany. Risk discrimination was quantified according to the history of colonoscopy and polypectomy by areas under the curves (AUCs) and their 95% confidence intervals (CIs). All statistical tests were two-sided. Results AUCs (95% CIs) were higher among subjects without previous colonoscopy (0.622 [0.606–0.639]) than among those with previous colonoscopy and polypectomy (0.568 [0.536–0.601], difference [Δ AUC] = 0.054, p = .004). Such differences were consistently seen in sex-specific groups (women: Δ AUC = 0.073, p = .02; men: Δ AUC = 0.046, p = .048) and age-specific groups (<70 years: Δ AUC = 0.052, p = .07; ≥70 years: Δ AUC= 0.049, p = .045). Conclusions Predictive performance of PRS may be underestimated in populations with widespread use of colonoscopy. Future studies using PRS to develop CRC prediction models should carefully consider colonoscopy history in order to provide more accurate estimates.

show abstract

“…Several countries provide an opportunistic screening programme including colonoscopy (Austria, Czech Republic, Greece, Iceland, Luxembourg, Portugal, Slovakia); in very few countries organized screening programs offer either colonoscopy (Germany, Poland) or sigmoidoscopy (England and Italy). The United States and South Korea offer both endoscopic screenings, reporting uptake of up to 60% [ 5 ]. Screening colonoscopy has the advantage that adenomas can be detected and removed in the entire colon and rectum but the procedure requires full bowel cleansing starting the day before colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

Effects of Alternative Offers of Screening Sigmoidoscopy and Colonoscopy on Utilization and Yield of Endoscopic Screening for Colorectal Neoplasms: Protocol of the DARIO Randomized Trial

Schrotz‐King¹,

Hoffmeister²,

Sauer³

et al. 2020

JMIR Res Protoc

Self Cite

View full text Add to dashboard Cite

Background Flexible sigmoidoscopy and colonoscopy are recommended screening options for colorectal cancer (CRC). Despite colonoscopy being offered for CRC screening in Germany, the uptake of this offer has been very limited. Objective The objective of this study was to assess the potential for increasing use of endoscopic CRC screening and the detection of advanced colorectal neoplasms by offering the choice between use of flexible sigmoidoscopy and colonoscopy. Methods The DARIO study includes a cross-sectional study (part I), followed by a prospective 2-arm randomized controlled intervention trial (part II) with an associated biobank study (part III). Participation is possible in part I of the DARIO study only, parts I and II, or all 3 study parts. After obtaining informed consent from the municipalities, 12,000 people, aged 50-54 years, from the Rhine-Neckar region in Germany were randomly selected from residential lists of the responsible population registries and invited to complete a standardized questionnaire to investigate the nature, frequency, timing, and results of previous CRC screening and eventual diagnostic colonoscopies. In study part II participants from study part I with no colonoscopy in the preceding 5 years are randomized into 2 arms: arm A offering screening colonoscopy only, and arm B offering both options, either screening colonoscopy or screening sigmoidoscopy. The primary endpoint is the proportion of participants in whom colorectal neoplasms >0.5 cm are detected and removed at screening endoscopy. The secondary endpoints are the detection rate of any neoplasm and use of any endoscopic screening. Part III of the study will use samples from participants in study part II to construct a liquid and tissue biobank for the evaluation of less invasive methods of early detection of colon cancer and for the more detailed characterization of the detected neoplasms. Blood, urine, stool, and saliva samples are taken before the endoscopy. Tissue samples are obtained from the neoplasms removed during endoscopy. Results A total of 10,568 from 12,000 randomly selected women and men aged 50-54 years living in the Rhine-Neckar-Region of Germany have been invited for participation. The remaining 1432 (11.93%) could not be invited because they reached the age of 55 at the time of contact. Of those invited, 2785/10,568 (26.35%) participated in study part I; 53.60% (1493/2785) of these participants were female. Study parts II and III are ongoing. Conclusions This study will answer the question if alternative offers of either screening sigmoidoscopy or screening colonoscopy will increase utilization and effectiveness of endoscopic CRC screening compared with an exclusive offer of screening colonoscopy. In addition, alternative noninvasive screening tests will be developed and validated. Trial Registration German Clinical Trials Register DRKS00018932; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00018932 International Registered Report Identifier (IRRID) DERR1-10.2196/17516

show abstract

Colonoscopy and Sigmoidoscopy Use among the Average-Risk Population for Colorectal Cancer: A Systematic Review and Trend Analysis

Cited by 25 publications

References 68 publications

Utilisation of Colorectal Cancer Screening Tests in European Countries by Type of Screening Offer: Results from the European Health Interview Survey

Utilisation of Colorectal Cancer Screening Tests in European Countries by Type of Screening Offer: Results from the European Health Interview Survey

Colorectal Cancer Risk by Genetic Variants in Populations With and Without Colonoscopy History

Effects of Alternative Offers of Screening Sigmoidoscopy and Colonoscopy on Utilization and Yield of Endoscopic Screening for Colorectal Neoplasms: Protocol of the DARIO Randomized Trial

Contact Info

Product

Resources

About