Value of Periodic Examinations in Detecting Cancer of the Rectum and Colon

Hertz, Ralph E.; Deddish, Michael R.; Day, Emerson

doi:10.1080/00325481.1960.11712835

Cited by 132 publications

(15 citation statements)

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“…Effectiveness h as not been well studied, but in an uncontrolled study 26,000 mostly asymptomatic subjects underwent 47 ,09 1 rig id proctosigmoidoscop1es which detected 58 cancers, 81 % of which were Dukes' stages A or B, with a 15 year survival of 90% (14) , while Gilbertsen (15) has shown a reduction in rectal cancer m pattents regularly sigmoidoscoped and whose polyps were removed. However, few o r no data are avai lable for the application of sigmoidoscopy, which h as been inc reasingly superceded by the flexible sigmoidoscope-most commo nly the 60 cm scope.…”

Section: Recent Screening Studiesmentioning

confidence: 99%

Screening by Colonoscopy - Has the Time Arrived?

Hunt

1990

Canadian Journal of Gastroenterology

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Colorectal cancer mortality may be reduced by several screening strategies -mathematical modelling suggests that mortality may be reduced by one-third in patients over the age of 40 years who undergo annual fecal occult blood testing. Similar modelling suggests that either colonoscopy or barium enema may reduce mortality by up to 85%. This paper reviews the evidence for different screening approaches for colorectal cancer, and identifies high risk groups in whom full colonoscopy has been studied. These studies include patients with first degree relatives with colorectal cancer, family cancer syndrome, prior breast, uterine or ovarian lesions, and follow-up for prior adenomatous polyps or cancer. The role of colonoscopy in the surveillance of patients with chronic total ulcerative colitis for dysplasia is also reviewed. The implications for patient management and possible clinical strategies are discussed. Can J Gastroenterol 1990;4(9):527-432 Depistage par colonoscopie -Le moment est~il arrive? RESUME: Plusieurs strategies de depistage permettent de reduire la morcalite pour cancer recrn-colique -les modeles mathematiques suggerent que la mortalite peut etre diminuee d'un tiers chez les patients ages de plus de 40 ans qui subissent annuellement des tests de depistage du sang occultc clans lcs selles. Des modeles similaires suggerent que la colonoscopie ou le lavement baryte permet une reduction pouvant atteindre 85 %. Le present article examine les diverses methodes de depistage du cancer recto-colique et definit les groupes a haut risque pour qui la colonoscopie complete a ete etudiee (patients dont un parent proche est porteur de cancer recto-colique, syndrome de cancer familial, antecedents de cancer du sein, de !'uterus ou des ovaires; suivi des patients ayant eu des antecedents de polypes adenomateux ou de cancer). La surveillance colonoscopique a la recherche de dysplasie des cas de colite ulcereuse chronique a forme pancolique est egalement examinee. Les implications de la prise en charge et les strategies cliniques possibles sont egalement proposees.

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Section: Recent Screening Studiesmentioning

confidence: 99%

Screening by Colonoscopy - Has the Time Arrived?

Hunt

1990

Canadian Journal of Gastroenterology

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“…2) and 65% of all malignant lesions of the large bowel [6, 15 19]. Careful periodic sigmoidoscopy of a high-risk group of patients has revealed a striking decrease in the incidence of rectal cancer [13,20].…”

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confidence: 99%

Reliability of routine double-contrast examination (DCE) of the large bowel in polyp detection: A prospective clinical study

Fork

Lindström

Ekelund

1983

Gastrointest Radiol

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A total of 2,118 consecutive patients, examined with double-contrast examination of the large bowel (DCE), were evaluated radiographically, clinically, and endoscopically for up to 48 months. A total of 402 polyps were diagnosed during the follow-up period. Of these, 307 were revealed at the first DCE and 95 at subsequent endoscopy or autopsy. The accuracy of the DCE for demonstrating or excluding patients with polypoid lesions of the colon was 97%, whereas the predictive value of a positive DCE report was 96% and a negative one, 97%. However, the ability to demonstrate every known polyp at DCE was only 63%, although the probability of a polypoid lesion demonstrated at DCE being a true polyp was 92%.

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“…Two studies utilizing sigmoidoscopy and polyp removal suggested that such a programme might reduce the incidence of colorectal cancer although no control observations were made (Hertz et al, 1960;Gilbertsen, 1973). Dales et al (1973) demonstrated reduced mortality from colorectal cancer utilizing sigmoidoscopy in a screened group compared with controls.…”

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confidence: 99%

Screening for colorectal cancer in a factory-based population with Fecatest

Lee¹

1983

Br J Cancer

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Summary This report concerns a screening programme for colorectal cancer using Fecatest, a relatively sensitive test for faecal occult blood, in a factory-based population. A total of 2420 workers between 40 and 65 years of age returned kits for testing following suitable dietary restriction. In Factory A, in which screening was offered as part of an annual medical examination, 989 men agreed to participate, a compliance rate of 45%. In Factory B, in which screening was offered in their weekly pay packets, 1431 men participated, a compliance rate of 22%. An overall positivity rate of 5.8% was found, 4.6% in Factory A and 6.6% in Factory B. Five cancers were found, two of the rectum, one at the recto-sigmoid junction, one in the sigmoid colon and one in the transverse colon. Two of these lesions were at Dukes Stage A, one at Stage B and two at Stage C. In addition, 25 adenomatous polyps were found in 17 men. In 13 these were characterized as tubular adenomata and in 4 as tubulovillous adenomata. The mean age at diagnosis in the polyp cases was 52.6 years and in the cancer cases 58.8 years. Increased specificity is obtained by excluding participants below 46 years of age. The detection rate in the 46-65 year range is -1 in 100 for adenomatous polyps and 1 in 300 for cancer in the population screened. This detection rate is higher than most comparable studies using a less sensitive Guaiac test on older populations.

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Value of Periodic Examinations in Detecting Cancer of the Rectum and Colon

Cited by 132 publications

References 0 publications

Screening by Colonoscopy - Has the Time Arrived?

Screening by Colonoscopy - Has the Time Arrived?

Reliability of routine double-contrast examination (DCE) of the large bowel in polyp detection: A prospective clinical study

Screening for colorectal cancer in a factory-based population with Fecatest

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