Screening colonoscopy in the initial workup of bariatric surgery patients: guidelines are needed

Hadad, Mohammed Al; Dehni, Nidal; Alakhras, Abdullah; Ziaei, Yalda; Turrin, Nicolas P.; Nimeri, Abdelrahman

doi:10.1007/s00464-013-3358-9

Cited by 7 publications

(7 citation statements)

References 25 publications

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“…The current study showed that CRC occurred at a younger age in women (40 and 41 years), with the mean age at the time of CRC diagnosis being 58 ± 11.29 years for women and 69.33 ± 3 years for men. This finding is similar to that obtained in different studies conducted within UAE and the Gulf countries [ 22 – 24 ]. These findings support the recommendation of HAAD to start screening at 40 years of age, earlier than that followed in other countries [ 11 ].…”

Section: Discussionsupporting

confidence: 92%

Colorectal Cancer screening in ambulatory healthcare service clinics in Abu Dhabi, United Arab Emirates in 2015–2016

2021

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Background Colorectal cancer (CRC) is a major public health issue due to high morbidity and mortality. Different screening programs were implemented to reduce its burden. Objectives To estimate the prevalence of CRC screening uptake using fecal immunochemical test (FIT) or guaiac fecal occult blood testing (gFOBT) in Emirati nationals. Other objectives were to measure the incidence of CRC in the screened population, to measure the outcomes of follow-up screening colonoscopy after positive FIT/gFOBT and to identify the causes of not performing follow-up screening colonoscopy after positive FIT/gFOBT. Methodology Adult Emirati nationals aged 40–75 years who visited Ambulatory healthcare services clinics, Abu Dhabi in 2015–2016 were included in the study. The electronic medical records of the eligible individuals were reviewed retrospectively. The prevalence of CRC screening was measured among the eligible population using the FIT/gFOBT. The IBM SPSS Statistics program, version 21.0.0, was used for analysis. Result 45,147 unique individuals were eligible for screening, and only 23.5% were screened using FIT/gFOBT. Of the screened individuals, 13.5% had positive FIT/ gFOBT, and 30.5% of those underwent follow-up screening colonoscopy. CRC was diagnosed in 11 individuals. Colonic polyp were found in 30.5% of individuals who had undergone a follow-up colonoscopy. Collectively 933 individuals did not undergo follow-up screening colonoscopy after having a positive FIT/gFOBT, and about 36.3% had collected the result and referred to a gastroenterologist but did not attend the appointment. Conclusion CRC screening uptake using FIT/gFOBT is low among the adult Emirati nationals.

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Section: Discussionsupporting

confidence: 92%

Colorectal Cancer screening in ambulatory healthcare service clinics in Abu Dhabi, United Arab Emirates in 2015–2016

2021

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“…11, 12 Furthermore, guidelines for screening of individuals with obesity for colorectal cancer are undeveloped. 13 The assumption that bariatric surgeries reduce CRC risk has been recently tested. In a large cohort study of colorectal cancer incidence after bariatric surgery, standardized incidence ratio for CRC following bariatric surgery increased with time (95% confidence interval [CI]: 1.48–2.64) 10 years after surgery.…”

Section: Introductionmentioning

confidence: 99%

Bariatric Surgery Prior to Index Screening Colonoscopy Is Associated With a Decreased Rate of Colorectal Adenomas in Obese Individuals

Kedrin

Gandhi

Wolf

et al. 2017

Clinical and Translational Gastroenterology

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Objectives:Obesity is an important risk factor for the development of colorectal cancer (CRC). Although the impact of bariatric surgery on CRC is conflicting, its impact on precursor lesions is unknown. The aim of this study was to determine whether bariatric surgery before index screening colonoscopy is associated with decreased development of colorectal adenomas.Methods:We performed a retrospective cohort study of bariatric surgery patients who had undergone index, screening colonoscopy at an academic center from 2001 to 2014. Patients who had bariatric surgery at least 1 year before index colonoscopy were compared with those who had surgery after colonoscopy, using multivariable logistic regression to control for presurgical body mass index, sex, gender, race, type of surgery, aspirin use, metformin use, smoking, and age at colonoscopy.Results:One hundred and twenty-five obese individuals who had bariatric surgery before colonoscopy were compared with 223 individuals who had colonoscopy after surgery. Adenomatous polyps were found in 16.8% of individuals who had surgery first vs. 35.5% who had colonoscopy before bariatric surgery (unadjusted odds ratio (OR) 0.37, 95% confidence interval (CI): 0.21–0.64, P=0.0003). After multivariable adjustment, bariatric surgery before index screening colonoscopy was associated with a decreased risk of adenomas at index colonoscopy (adjusted OR 0.37, 95% CI: 0.19–0.69, P=0.002).Conclusions:Bariatric surgery is associated with a decreased risk of colorectal adenomas in obese individuals without a family history of CRC.

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“…The odds of adherence and use of different screening modalities for women were similar across all BMIs, yet for nonadherent women, more women with class III obesity reported "pain" and "embarrassment" as the reasons for nonadherence to screening compared to women of healthy weight (11.6% versus 2.6%, P 5 .002) [22]. When patients are screened, adenomatous polyps are detected at a higher rate as BMI increases [23].…”

Section: Colorectal Cancermentioning

confidence: 88%

“…The relationship between weight and CRC screening in men is inconsistent, while there is a trend toward lower CRC screening in women of higher weight [22]. The data for 8550 respondents aged 50 to 75 years in the 2010 National Health Interview Survey showed men with a BMI 40 kg/ m 2 were significantly less likely to adhere to screening guidelines compared with men of healthy weight (adjusted OR 5 .35, 95%CI: .17-.75); were less likely to have had an endoscopic examination (adjusted OR 5 .37, 95% CI: .18-.79); and had a trend toward lower fecal occult blood test use (adjusted OR 5 .42, 95% CI: .14-1.27) [23]. Men with obesity were more likely to state "lack of physician recommendation" as a reason for nonadherence to screening (29.7% obese class III versus 15.4% nonobese, P 5 .04).…”

Section: Colorectal Cancermentioning

confidence: 99%

ASMBS position statement on the relationship between obesity and cancer, and the role of bariatric surgery: risk, timing of treatment, effects on disease biology, and qualification for surgery

Ghiassi

Chaar

Aleassa

et al. 2020

Surgery for Obesity and Related Diseases

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Screening colonoscopy in the initial workup of bariatric surgery patients: guidelines are needed

Abstract: The risk for the development of colonic adenomatous polyps and cancer is high among young obese individuals in the Middle East. Guidelines are needed to establish criteria for screening in this group of individuals.

Cited by 7 publications

References 25 publications

Colorectal Cancer screening in ambulatory healthcare service clinics in Abu Dhabi, United Arab Emirates in 2015–2016

Colorectal Cancer screening in ambulatory healthcare service clinics in Abu Dhabi, United Arab Emirates in 2015–2016

Bariatric Surgery Prior to Index Screening Colonoscopy Is Associated With a Decreased Rate of Colorectal Adenomas in Obese Individuals

ASMBS position statement on the relationship between obesity and cancer, and the role of bariatric surgery: risk, timing of treatment, effects on disease biology, and qualification for surgery

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