Mobile colonoscopic surveillance provides quality care for hereditary nonpolyposis colorectal carcinoma families in South Africa

Anderson, David W.; Goldberg, P. A.; Algar, Ursula; Felix, Rebecca; Ramesar, Raj

doi:10.1111/j.1463-1318.2006.01172.x

Cited by 21 publications

(19 citation statements)

References 18 publications

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“…Seven subjects (5%) in the surveillance group and six (12%) in the nonsurveillance group were lost to follow up, so the follow-up rates in the two groups were similar (P = 0.22). During this period, the surveillance group underwent a median of three colonoscopies (range [1][2][3][4][5][6][7][8][9][10][11][12].…”

Section: Resultsmentioning

confidence: 99%

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Surveillance colonoscopy improves survival in a cohort of subjects with a single mismatch repair gene mutation

et al. 2009

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Section: Resultsmentioning

confidence: 99%

“…Most mutation carriers live in a remote part of the Northern Cape Province of South Africa, with limited access to health care, and almost no access to endoscopic services. The mobile colonoscopic service offered to these patients has been described previously [5].…”

Section: Introductionmentioning

confidence: 99%

Surveillance colonoscopy improves survival in a cohort of subjects with a single mismatch repair gene mutation

et al. 2009

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“…Mobile screening vans have been found to be effective instruments in increasing population participation in screening (in and outside the U.S.) for cervical(31), colon(32), breast(33) and lung(34) cancer with no decrement in accuracy, in a cost-effective manner(35). A survey study conducted by us previously suggested that participation in BE screening may increase by the use of mobile screening(15).…”

Section: Discussionmentioning

confidence: 99%

A Randomized Comparative Effectiveness Trial of Novel Endoscopic Techniques and Approaches for Barrett’s Esophagus Screening in the Community

Sami

Dunagan

Johnson

et al. 2015

American Journal of Gastroenterology

124

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Objectives To compare participation rates and clinical effectiveness of sedated endoscopy (sEGD) versus unsedated transnasal endoscopy (uTNE) for esophageal assessment and Barrett's esophagus (BE) screening in a population-based cohort. Methods Prospective, randomized, controlled trial in a community population. Subjects, ≥ 50 years of age who previously completed validated gastrointestinal symptom questionnaires were randomized (stratified by age, sex and reflux symptoms) to one of three screening techniques (either sEGD, or uTNE in a mobile research van (muTNE), or uTNE in a hospital outpatient endoscopy suite (huTNE)) and invited to participate. Results 209 of 459 (46%) subjects agreed to participate (muTNE n=76, huTNE n=72, sEGD n=61). Participation rates were numerically higher in the unsedated arms of muTNE (47.5%) and huTNE (45.7%) compared to the sEGD arm (40.7%), but were not statistically different (p=0.27). Complete evaluation of the esophagus was similar using muTNE (99%), huTNE (96%) and sEGD (100%) techniques (p=0.08). Mean recovery times (minutes) were longer for sEGD (67.3) compared to muTNE (15.5) and huTNE (18.5) (p<0.001). Approximately, 80% of uTNE subjects were willing to undergo the procedure again in future. 29% and 7.8% of participating subjects had esophagitis and BE respectively. Conclusions Mobile van and clinic uTNE screening had comparable clinical effectiveness with similar participation rates and safety profile to sEGD. Evaluation time with uTNE was significantly shorter. Prevalence of BE and esophagitis in community subjects ≥ 50 years of age was substantial. Mobile and outpatient unsedated techniques may provide an effective alternative strategy to sEGD for esophageal assessment and BE screening.

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“…This is especially important in our setting where we have limited resources available for screening, and most of these families live in areas with little access to health care. We have previously reported the effectiveness of a mobile endoscopy service which has been designed to provide a surveillance colonoscopy service to at-risk individuals in remote areas of the Northern Cape Province of south Africa [4].…”

Section: Introductionmentioning

confidence: 99%

Cancer risk in a cohort of subjects carrying a single mismatch repair gene mutation

et al. 2009

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Hereditary non-polyposis colon cancer (HNPCC) is an autosomal dominant condition, caused by germline mutations in the mismatch repair genes, that presents with colorectal cancers at a young age, as well as extracolonic tumours. One of the causative mutations is the C1528T (Exon 13) mutation of the MLH1 gene. The purpose of this study is to document the cancer risk for subjects who carry this mutation. This is a prospective cohort study of 200 subjects who carry this mutation. We calculated the risk of developing colorectal cancer only in those subjects who had not undergone surveillance colonoscopy. The incidence of extracolonic cancers (for which surveillance is not routinely offered) was determined for the entire cohort. The results of the study are among the 71 subjects who did not undergo surveillance colonoscopy, colorectal cancers occurred in 36 (51%). They occurred at a median age of 44 years (range 17-73). Using Kaplan-Meier estimates, the risk of developing a colorectal cancer by age 65 was 92%. Eighteen subjects in the cohort of 200 were diagnosed with extracolonic tumours. The most common extracolonic malignancies were breast (6/98 women) and endometrial (3/98 women). Thus this mutation has a high penetrance for colorectal cancer, but is not associated with a high risk of developing extracolonic malignancies.

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Mobile colonoscopic surveillance provides quality care for hereditary nonpolyposis colorectal carcinoma families in South Africa

Abstract: The mobile service provides access to colonoscopy in remote areas without compromising the quality of service.

Cited by 21 publications

References 18 publications

Surveillance colonoscopy improves survival in a cohort of subjects with a single mismatch repair gene mutation

Surveillance colonoscopy improves survival in a cohort of subjects with a single mismatch repair gene mutation

A Randomized Comparative Effectiveness Trial of Novel Endoscopic Techniques and Approaches for Barrett’s Esophagus Screening in the Community

Cancer risk in a cohort of subjects carrying a single mismatch repair gene mutation

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