Colorectal Carcinoma Screening in Lagos, Nigeria, Are We Doing it Right?

Onyekwere, Charles; Ogbera, Anthonia O; Abdulkareem, F B; Ashindoitiang, John

doi:10.4021/gr2009.01.1256

Cited by 4 publications

(6 citation statements)

References 11 publications

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“…Similarly Baxter et al studied the relationship between endoscopist characteristics determined from administrative data and occurrence of interval CRC in over 14 000 patients undergoing colonoscopy during a five-year period. The present finding is a reflection of low level of colonoscopy practice as had been reported earlier [10, 11]. High cost of colonoscopy services, low infrastructure, and awareness amongst other factors may be partly responsible.…”

Section: Discussionsupporting

confidence: 77%

“…The few African reports [10, 11] showed indications and findings in relatively small study population with a number of them revealing advanced presentation of most cases of CRC in line with observed pattern in regions of low CRC screening [12, 13]. Also a report [14] of colonoscopy outcome from a tertiary hospital in Jos in Northern Nigeria showed polyp detection rate of 6%, a figure much less than that from Western countries.…”

Section: Introductionmentioning

confidence: 70%

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Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

Onyekwere

Odiagah

Ogunleye

et al. 2013

Diagnostic and Therapeutic Endoscopy

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Background. Colonoscopy effectiveness depends on the quality of the examination. Community-based report of quality of colonoscopy practice in a developing country will help in determining standard and also serve as a stimulus for improvement in service. Aim. To review the quality of colonoscopy practice and document pattern of colonic disease including polyp detection rate in Lagos, Nigeria. Method. A protocol that captured the patients' demographics, indication, and some quality indices of colonoscopy was developed and sent to all the identified colonoscopy units in Lagos to complete for all procedures performed between January 2011 and June 2012. All data were collated and analyzed. The quality indices studied were compared with guideline standard. Results. Twelve colonoscopy centers were identified but only nine centers responded. The gastroenterologist/endoscopists were physicians (3) and surgeons (5). Six hundred and seven colonoscopy procedures were performed during this period (M : F = 333 : 179) while the sex was not disclosed in 95 subjects. The examination indications were lower GI bleeding (24.2%), altered bowel habits (9.2%), lower abdominal pain (9.1%), screening for CRC (4.3%) and unspecified (46.8%). Conscious sedation was generally used while bowel preparation (good in 81.4%) was done with low residue diet and stimulant laxatives. Caecal intubation rate was 81.2%. Common endoscopic findings were haemorrhoids (43.2%), polyps/masses (13.4%), diverticulosis (11.1%), and no abnormality (23.4%). Polyp was detected in 6.8% of cases. Conclusion. Colonoscopy utilization is low, and the quality of practice is suboptimal; although limited resources could partly explain this, however it is not clear if the low rate of polyp detection is due to missed lesions or low population incidence.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 70%

Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

Onyekwere

Odiagah

Ogunleye

et al. 2013

Diagnostic and Therapeutic Endoscopy

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“…A range of studies from across the globe have shown improved outcomes in patients who had as little as a single rectosigmoidoscopy done before the age of 50 and this benefit is said to increase with another such screen years after [ 23 – 29 ]. Bearing in mind that a recent mathematical modelling study showed that in the sub-Saharan African region, screening for CRC by colonoscopy at age 50 years in combination with treatment can be considered cost-effective and that the present rates of CRC screening of any kind in our environment are abysmal [ 30 , 31 ], rectosigmoidoscopy would appear to be a most screening tool. Particularly as it has the added advantage that it is cheaper, faster, easier to perform, training requirements are less and the rigors of bowel preparation demands are much reduced.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria

Oluyemi¹,

Awolola²,

Oyedeji³

2016

Pan Afr Med J

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IntroductionColorectal polyps are known precursors of colorectal cancers. The increase in utilization of colonoscopy in Nigeria has meant a rise in the recently reported incidence of these lesions. The aim of this study is to evaluate the clinicopathological profile of colorectal polyps biopsied during the inaugural 12 month period of colonoscopy from a private endoscopy suite in Nigeria.MethodsThis is a retrospective review of all the clients who had polyps diagnosed at colonoscopy over a 12 month period (August 2014 –July 2015) at a private endoscopy suite in Lagos, Nigeria. This analysis of prospectively collected data was performed using clinical information from the endoscopy logs and pathology database system of a private endoscopy suite based in Lagos, Nigeria.ResultsA total of 125 colonoscopies were carried out over the stated period. Of these, 14 individuals had a total of 18 polyps- 4 clients (28.6% of the persons with polyps) had two polyps each. The polyp detection rate was 11.2% while the polyp per colonoscopy rate was 14.4%. Of these clients, males were 10 in number; giving a male to female ratio of 2.5:1. Their ages ranged from 37 to 77 years (mean= 57.3 years). The presenting complaint at colonoscopy was hematochezia in 11 (78.6%), new onset constipation in 2 (14.2%) and peri-anal pain in 1 patient (7.1%). The polyps were distributed as follows; 2 (11.1%) in the ascending colon, 1 (5.6%) each in the transverse and descending colons, 8 (44.4%) in the sigmoid colon, 6(33.3%) located in the rectum. Hence, there was left sided (15 of 18= 83.3%) preponderance. Pathologically, tubular (adenomatous) polyp with or without low grade dysplastic changes was diagnosed in 6 of the 18 polyps (giving an adenoma detection rate of 4.8%), 4 (22.2%) were inflammatory polyps, 1 (5.6%) was malignant and another had the rare inflammatory fibroid polyp. Five (27.8%) of the specimens were reported as non-specific colitis.ConclusionThe study supports the present wisdom that polyps are clearly less prevalent in our environment when compared to the Western world. The increased prevalence with advancing age, in male subjects and of left sided lesions, is also in keeping with previous results from our environment. A case is also advanced for the increased deployment of endoscopy as a tool for the detection of these polyps and ultimately, the reduction of colorectal cancer in our population.

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“…It is intriguing to note that whereas Arigbabu et al 4 in Ile-Ife recorded 562 colonoscopies over a four year period (1978)(1979)(1980)(1981)(1982), giving an average of 140 cases per year (i.e 12 cases per month), Alatise et al recorded 320 cases over a five year period (2007)(2008)(2009)(2010)(2011) in the same tertiary health institution twenty nine years later, giving an average of 64 cases per year or 5 cases per month. This clearly shows a marked decline in the number of colonoscopies done in this centre and the reason for this drop is puzzling since the incidence of conditions requiring colonoscopy such as colorectal carcinoma are on the increase in Nigeria 3,7,12 . The data by Alatise et al when compared with our present data will only be 10 cases above what we had in 6 months which suggest that the number in our study may not be considered small.…”

Section: Discussionmentioning

confidence: 99%

“…Colorectal cancer continues to be a burden worldwide , with increasing incidence in different parts of the world 3,5,6,8,9 . Onyekwere et al 12 cited a recent study in Ibadan ,South West, Nigeria, with an 81% increase in the incidence of colorectal carcinoma over a period of two decades 12 .Screening colonoscopy especially where fecal occult blood is positive is an important diagnostic tool that can reverse the current trend of late presentation of patients with colorectal carcinoma [1][2][3][4][5][6][7]10 .…”

Section: Introductionmentioning

confidence: 99%

Pioneering Video Colonoscopy In Calabar, South-South, Nigeria: A Six-Month Prospective Study.

Ngim¹

2014

IOSR-JDMS

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Colorectal Carcinoma Screening in Lagos, Nigeria, Are We Doing it Right?

Cited by 4 publications

References 11 publications

Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

Colonoscopy Practice in Lagos, Nigeria: A Report of an Audit

Clinicopathologic review of polyps biopsied at colonoscopy in Lagos, Nigeria

Pioneering Video Colonoscopy In Calabar, South-South, Nigeria: A Six-Month Prospective Study.

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