PTU-041 Colonoscopic perforations in the english nhs bowel cancer screening programme (nhsbcsp)

Derbyshire, Edmund; Nickerson, Claire; Hungin, A. P. S.; Rutter,

doi:10.1136/gutjnl-2015-309861.156

Cited by 2 publications

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“…However, due to the low PPV, many participants undergoing repeat screening will be subject to additional unnecessary diagnostic investigation, with the accompanying risk of adverse events, such as colonoscopic perforation, and the potential for psychological distress. [22][23][24][25] Furthermore, additional colonoscopies will increase cost and place additional demand on overburdened endoscopy services.…”

Section: Discussionmentioning

confidence: 99%

High test positivity and low positive predictive value for colorectal cancer of continued faecal occult blood test screening after negative colonoscopy

Brown

Wooldrage

Wright³

et al. 2017

J Med Screen

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ObjectivesThe English Bowel Cancer Screening Programme offers biennial guaiac faecal occult blood test (gFOBT) screening to 60–74-year-olds. Participants with positive results are referred for follow-up, but many do not have significant findings. If they remain age eligible, these individuals are reinvited for gFOBT screening. We evaluated the performance of repeat screening in this group.MethodsWe analysed data on programme participants reinvited to gFOBT screening after either previous negative gFOBT (n = 327,542), or positive gFOBT followed by a diagnostic investigation negative for colorectal cancer (CRC) or adenomas requiring surveillance (n = 42,280). Outcomes calculated were uptake, test positivity, yield of CRC, and positive predictive value (PPV) of gFOBT for CRC.ResultsFor participants with a previous negative gFOBT, uptake in the subsequent screening round was 87.5%, positivity was 1.3%, yield of CRC was 0.112% of those adequately screened, and the PPV of gFOBT for CRC was 9.1%. After a positive gFOBT and a negative diagnostic investigation, uptake in the repeat screening round was 82.6%, positivity was 11.3%, CRC yield was 0.172% of participants adequately screened, and the PPV of gFOBT for CRC was 1.7%.ConclusionWith high positivity and low PPV for CRC, the suitability of routine repeat gFOBT screening in two years among individuals with a previous positive test and a negative diagnostic examination needs to be carefully considered.

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Section: Discussionmentioning

confidence: 99%

High test positivity and low positive predictive value for colorectal cancer of continued faecal occult blood test screening after negative colonoscopy

Brown

Wooldrage

Wright³

et al. 2017

J Med Screen

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“…Derbyshire et al aimed to evaluate the overall rate of perforations in the English National Health Service Bowel Cancer Screening Programme consisting of over 263 129 endoscopic procedures carried out in more than 31 bowel cancer screening centers. 1 Overall, 147 perforations were identified (rate of 0.06%). 69.2% of perforations were therapeutic and the endoscopists visualized the perforation in 12.8% of cases.…”

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confidence: 99%

United European Gastroenterology Week review: Endoscopy and inflammatory bowel disease

Neumann

2016

Digestive Endoscopy

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W ITH OVER 13 000 participants every year, United European Gastroenterology (UEG) Week is one of the most important events in gastroenterology. In 2015, Barcelona was the host city for UEG Week and attendees were invited to join a broad spectrum of lectures, courses and live demonstrations throughout the disciplines of general medicine, surgery, pediatrics, gastrointestinal (GI) oncology and endoscopy.As UEG Week is one of the most important medical events, every year, new medical devices are launched at the conference and the GI community introduces the latest research activities in their field. Although the present article cannot summarize every excellent research presentation, it will highlight some of the most exciting new developments in the field of endoscopy and irritable bowel disease (IBD).Perforation is a redoubtable complication during endoscopy. Derbyshire et al. aimed to evaluate the overall rate of perforations in the English National Health Service Bowel Cancer Screening Programme consisting of over 263 129 endoscopic procedures carried out in more than 31 bowel cancer screening centers. 1 Overall, 147 perforations were identified (rate of 0.06%). 69.2% of perforations were therapeutic and the endoscopists visualized the perforation in 12.8% of cases. Endoscopic clipping was carried out in 10.2%. In contrast, most diagnostic perforations occurred in the sigmoid colon. Surgery was done in 54.8% of patients and diagnostic perforations were significantly more often associated with the need for surgery. Of note, a stoma was formed in 26.1% of those having surgery. Diagnostic perforations and surgery were both significantly associated with post-perforation morbidity. Median hospital stay was 9.5 days in this largest multicenter study specifically reporting outcomes after colonoscopic perforation in Europe and 25.2% of patients were admitted to the intensive care unit. Overall mortality rate was calculated as 0.87%.Newest advanced endoscopic imaging modalities aim for better characterization of the mucosal vascular pattern in order to identify predictive markers for invasion and therapeutic response. Kaneko and coworkers introduced the first clinical trial of novel hypoxia imaging in human cancers, including pharyngeal, esophageal, gastric, and colorectal neoplasia. 2 First, the authors determined the corresponding areas of neoplastic and non-neoplastic areas in the endoscopic images and obtained oxygen saturation levels. Afterwards, the authors investigated the changes of hypoxia imaging before and after chemotherapy, and the efficacy of chemotherapy in advanced cancers of the esophagus, stomach, and colorectum. To compare the results with the histological findings, all patients received endoscopic resection of the targeted lesion. Forty patients were studied and hypoxia imaging with the novel laser endoscope allowed for visualization of spatial and temporal information of hypoxic conditions in adenomas, early cancers and advanced cancers. The authors concluded that hypoxia imaging now illustrates a nov...

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PTU-041 Colonoscopic perforations in the english nhs bowel cancer screening programme (nhsbcsp)

Cited by 2 publications

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High test positivity and low positive predictive value for colorectal cancer of continued faecal occult blood test screening after negative colonoscopy

High test positivity and low positive predictive value for colorectal cancer of continued faecal occult blood test screening after negative colonoscopy

United European Gastroenterology Week review: Endoscopy and inflammatory bowel disease

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