| Colorectal cancer screening in evolution: Japan and the USA. | |
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MedLine Citation:
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PMID: 20586866 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Colorectal cancer (CRC) is one of the most common cancers in both Japan and the USA. Age-adjusted incidence of CRC has been in decline in the USA since 1985, while rates in Japan have been increasing. The decline in the USA is commonly attributed to CRC screening programs but there is little direct evidence to support this assertion. The current screening recommendations in the USA cover several options including colonoscopy and computerized tomographic colonography (CTC). The Japanese CRC screening program is centered on fecal immunochemistry testing (FIT). The US government Medicare program's approval of colonoscopy as a primary screening test has lead to a large increase in the number of patients undergoing the procedure. However, the benefit achieved from this change in screening program emphasis is not clear. Simulation models demonstrate that a screening program centered on FIT achieves 94% of the benefit that an all-colonoscopy program is able to accomplish but at a lower cost per life year gained. Clinical studies of colonoscopy have failed to demonstrate the 76-90% declines in CRC incidence predicted by the National Polyp Study published in 1993. A potential reason for this failure is the quality of colonoscopy performance. Until more compelling data becomes available demonstrating the utility of colonoscopy as a primary screening modality, there is little incentive to alter the proven cost-effective approach to CRC screening currently in practice in Japan. |
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Authors:
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William A Ross |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of gastroenterology and hepatology Volume: 25 Suppl 1 ISSN: 1440-1746 ISO Abbreviation: J. Gastroenterol. Hepatol. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-06-30 Completed Date: 2010-10-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607909 Medline TA: J Gastroenterol Hepatol Country: Australia |
Other Details:
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Languages: eng Pagination: S49-56 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. wross@mdanderson.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Canada
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epidemiology Colonography, Computed Tomographic / trends Colonoscopy / trends Colorectal Neoplasms / diagnosis*, economics, epidemiology Computer Simulation Cost-Benefit Analysis Evidence-Based Medicine Health Care Costs Humans Incidence Japan / epidemiology Mass Screening / economics, trends* Models, Economic Practice Guidelines as Topic Predictive Value of Tests Quality Indicators, Health Care / trends Time Factors United States / epidemiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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