Document Detail


Risk analyses for screening sigmoidoscopy based on a colorectal cancer (CRC) population.
MedLine Citation:
PMID:  18836946     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Although colonoscopy can be effective in the prevention of colorectal cancer (CRC), it requires many endoscopic facilities, has a high patient burden and risk of complications, and it is expensive. The aim of this study was to determine the risk for proximal CRC and to identify subgroups in which screening sigmoidoscopy can be effective. MATERIAL AND METHODS: A database search was carried out on all patients who underwent endoscopy of the lower gastrointestinal (GI) tract between 1997 and 2005. All patients diagnosed with CRC were included. Variables including age, gender and the presence of distal colonic neoplasia were used for risk analyses. RESULTS: In total, 783 patients were diagnosed with CRC. Tumour was located in the proximal colon in 68/255 (27%) of the patients <65 years. Of the patients <65 years, 22% (57/255) had proximal CRC without synchronous distal lesions and would thus have been missed by sigmoidoscopy screening. Among patients >65 years, 41% (216/528) were diagnosed with proximal CRC, significantly more often in women than in men (p <0.001). In 35% of patients (185/528) proximal CRC without distal colonic neoplasia was found, significantly more than in those under 65 years of age (p <0.001). CONCLUSIONS: Significantly more proximal localized CRC would have been missed by sigmoidoscopy screening in elderly patients, especially in women. In subjects <65 years of age, sigmoidoscopy screening allows detection of almost 80% of CRC cases and might suffice as a screening method.
Authors:
Sanna A Mulder; Rob J Th Ouwendijk; Raimond W Giard; Monique E Van Leerdam; Ernst J Kuipers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  44     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2009  
Date Detail:
Created Date:  2009-01-23     Completed Date:  2009-06-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  205-10     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Ikazia Hospital, Rotterdam, The Netherlands. S.mulder.1@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Colorectal Neoplasms / diagnosis*,  epidemiology*,  pathology
Female
Humans
Male
Mass Screening
Middle Aged
Neoplasm Staging
Prevalence
Risk Assessment
Risk Factors
Sigmoidoscopy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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