Screening for Colon Cancer

Winawer, Sidney J.; Sherlock, Paul; Schottenfeld, David; Miller, Daniel G.

doi:10.1016/s0016-5085(76)80276-4

Cited by 146 publications

(53 citation statements)

References 26 publications

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“…Previous studies have noted colonic polyps in up to 53% of patients, although the incidence is lower (9-35%) if only adenomatous polyps are considered (Klein et al, 1982;Ituarte et al, 1984;Brunner et al, 1990;Vasen et al, 1994;Ortego et al, 1994;Ladas et al, 1994). Nonetheless, this is generally higher than that for the normal population, and represents a major risk factor for the development of colonic carcinoma, as these lesions are premalignant (Winawer et al, 1976).…”

Section: Discussionmentioning

confidence: 95%

Increased incidence of neoplasia in females with acromegaly

Cheung

Boyages

1997

Clinical Endocrinology

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Section: Discussionmentioning

confidence: 95%

Increased incidence of neoplasia in females with acromegaly

Cheung

Boyages

1997

Clinical Endocrinology

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“…Unfortunately, at the present time in this country this is only possible for colon cancer. 35 For upper gastrointestinal cancer the approach is much more difficult. There are some patients at higher risk for upper gastrointestinal cancer such as patients with pernicious anemia, previous subtotal gastric resection, previous gastric polyps, poly-posis syndromes, and possibly, Barrett's esophagus and achalasia.l.3.6,10.2','2Q Overall, the yield of cancer in this group is small, except possibly for those with pernicious anemia; there is no suitable simple screening method available for the rest of the population.…”

Section: Perspectivementioning

confidence: 99%

The role of upper gastrointestinal endoscopy in patients with cancer

Winawer

Sherlock

Hajdu

1976

Cancer

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The last decade has seen considerable advance in the application of fiberoptic endoscopy to the diagnosis and management of patients with cancer. Forward and side-viewing instruments have been developed that have complete tip control, potential for obtaining directed biopsies, brush and lavage cytology, and for aspiration of material for assay of enzymes and tumor-associated antigens. These features have provided a high degree of diagnostic capability in the esophagus, stomach, and duodenum. Accurate histologic diagnoses require multiple biopsies and brush cytology from each lesion. Lavage cytology has been useful in selected patients, especially those with diffusely infiltrating lesions. Brush cytology has been especially helpful in patients with stenotic esophageal cancer. These techniques have also provided a diagnosis in a high percentage of patients with lymphoma involving the stomach. Endoscopy has also been very useful in patients with nongastrointestinal cancer who have major gastrointestinal problems such as bleeding stress ulcers or monilial esophagitis.

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“…1 Detecting cancer or one of its precursors at an early stage can prevent premature death and may reduce cancer morbidity, since treatment for earlier-stage cancers is less aggressive than that for more advanced stage cancers. 2 The high incidence of CRC, the high burden of disease, the availability of screening tests and of effective treatment of adenomas make CRC a likely candidate for population screening.Colonoscopy is the reference standard for the detection of advanced adenoma and cancer in CRC screening. As it is a burdensome and costly procedure, fecal immunochemical test (FIT) is often used as a noninvasive triaging test for colonoscopy in CRC screening programs.…”

mentioning

confidence: 99%

Risk factors for false positive and for false negative test results in screening with fecal occult blood testing

Stegeman

Wijkerslooth

Stoop

et al. 2013

Intl Journal of Cancer

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Differences in the risk of a false negative or a false positive fecal immunochemical test (FIT) across subgroups may affect optimal screening strategies. We evaluate whether subgroups are at increased risk of a false positive or a false negative FIT result, whether such variability in risk is related to differences in FIT sensitivity and specificity or to differences in prior CRC risk. Randomly selected, asymptomatic individuals were invited to undergo colonoscopy. Participants were asked to undergo one sample FIT and to complete a risk questionnaire. We identified patient characteristics associated with a false negative and false positive FIT results using logistic regression. We focused on statistically significant differences as well as on variables influencing the false positive or negative risk for which the odds ratio exceeded 1.25. Of the 1,426 screening participants, 1,112 (78%) completed FIT and the questionnaire; 101 (9.1%) had advanced neoplasia. 102 Individuals were FIT positive, 65 (64%) had a false negative FIT result and 66 (65%) a false positive FIT result. Participants at higher age and smokers had a significantly higher risk of a false negative FIT result. Males were at increased risk of a false positive result, so were smokers and regular NSAID users. FIT sensitivity was lower in females. Specificity was lower for males, smokers and regular NSAID users. FIT sensitivity was lower in women. FIT specificity was lower in males, smokers and regular NSAID users. Our results can be used for further evidence based individualization of screening strategies.Colorectal cancer (CRC) is one of the leading causes of cancer related death. 1 Detecting cancer or one of its precursors at an early stage can prevent premature death and may reduce cancer morbidity, since treatment for earlier-stage cancers is less aggressive than that for more advanced stage cancers. 2 The high incidence of CRC, the high burden of disease, the availability of screening tests and of effective treatment of adenomas make CRC a likely candidate for population screening.Colonoscopy is the reference standard for the detection of advanced adenoma and cancer in CRC screening. As it is a burdensome and costly procedure, fecal immunochemical test (FIT) is often used as a noninvasive triaging test for colonoscopy in CRC screening programs. Given its considerable false negative rate in the detection of advanced neoplasia, FIT should be applied at regular intervals for an optimal preventive effect. 3 With a specificity of 94% at the 50 ng/ml cut off, the accuracy of FIT based screening is suboptimal. 3 A

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Screening for Colon Cancer

Cited by 146 publications

References 26 publications

Increased incidence of neoplasia in females with acromegaly

Increased incidence of neoplasia in females with acromegaly

The role of upper gastrointestinal endoscopy in patients with cancer

Risk factors for false positive and for false negative test results in screening with fecal occult blood testing

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