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Huang J, Chen Y, Liu G, Tu W, Bergquist R, P Ward M, Zhang J, Xiao S, Hong J, Zhao Z, Li X, Zhang Z. Optimizing allocation of colorectal cancer screening hospitals in Shanghai: a geospatial analysis. GEOSPATIAL HEALTH 2023; 18. [PMID: 37401409 DOI: 10.4081/gh.2023.1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/21/2023] [Indexed: 07/05/2023]
Abstract
Screening programmes are important for early diagnosis and treatment of colorectal cancer (CRC) but they are not equally efficient in all locations. Depending on which hospital people belong to, they often are not willing to follow up even after a positive result, resulting in a lower-than-expected overall detection rate. Improved allocation of health resources would increase the program's efficiency and assist hospital accessibility. A target population exceeding 70,000 people and 18 local hospitals were included in the investigation of an optimization plan based on a locationallocation model. We calculated the hospital service areas and the accessibility for people in communities to CRC-screening hospitals using the Huff Model and the Two-Step Floating Catchment Area (2SFCA) approach. We found that only 28.2% of the residents with initially a positive screening result had chosen followup with colonoscopy and significant geographical differences in spatial accessibility to healthcare services indeed exist. The lowest accessibility was found in the Southeast, including the Zhangjiang, Jichang and Laogang communities with the best accessibility mainly distributed near the city centre of Lujiazui; the latter also had relatively a high level of what is called "ineffective screening" as it represents wasteful resource allocation. It is recommended that Hudong Hospital should be chosen instead of Punan Hospital as the optimization, which can improve the service population of each hospital and the populations served per colonoscope. Based on our results, changes in hospital configuration in colorectal cancer screening programme are needed to achieve adequate population coverage and equitable facility accessibility. Planning of medical services should be based on the spatial distribution trends of the population served.
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Affiliation(s)
- Jiaqi Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Yichen Chen
- Center for Disease Control and Prevention, Pudong New Area, Shanghai.
| | - Gu Liu
- Department of General Surgery, the first people's Hospital of Chenzhou, Hunan.
| | - Wei Tu
- Department of Geology and Geography, Georgia Southern University, Statesboro, GA.
| | | | - Michael P Ward
- Faculty of Veterinary Science, University of Sydney, NSW.
| | - Jun Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Shuang Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Jie Hong
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Zheng Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
| | - Xiaopan Li
- Department of Health Management Centre, Zhongshan Hospital, Fudan University, Shanghai, China; Office of Scientific Research and Information Management, Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai.
| | - Zhijie Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai.
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Spatial and temporal patterns of colorectal cancer in Asia, 1990-2019. Int J Clin Oncol 2023; 28:255-267. [PMID: 36520255 DOI: 10.1007/s10147-022-02274-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Asia accounts for the largest burden of colorectal cancer (CRC) worldwide. This study examines the temporal patterns of CRC in Asia in the last three decades. METHODS The data pertaining to CRC burden measured by incidence, mortality, and disability-adjusted-life-years (DALYs) and its risk factors for 49 countries in the Asian continent were drawn from the Global Burden of Disease 2019 study between 1990 and 2019. Mortality-to-incidence ratio (MIR) was employed as a proxy indicator of 5-year survival rates. RESULTS In Asia, incident cases more than tripled from 270,851 to 1.1 million, deaths tripled from 183,252 to 560,426, and DALYs more than doubled from 5 million to 13.4 million between 1990 and 2019. The age-standardized incidence rate (ASIR) increased from 14.0/100,000 to 23.9/100,000, age-standardized mortality rate (ASMR) increased from 10.1/100,000 to 12.5/100,000, and MIR decreased from 0.68 to 0.50 between 1990 and 2019. ASIR varied 10-folds across countries from 5.6/100,000 in Bangladesh to 62.0/100,000 in Taiwan in 2019 and ASMR from 4.9/1000 in Bangladesh to 30.3/100,000 in Brunei. In 2019, diet low in milk (18.7%) and whole grains (15.2%) and calcium (16.6%) were the major contributory risk factors in CRC DALYs in 2019. CONCLUSION CRC is a fast-rising neoplasm in Asia and its burden can be curtailed by focusing on primary prevention (e.g., diet and physical activity) and secondary prevention through screening. The policy focus and resources must be directed towards capacity building, including cancer infrastructure and quality data availability from cancer registries.
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Syed Soffian SS, Mohammed Nawi A, Hod R, Abdul Manaf MR, Chan HK, Abu Hassan MR. Disparities in Recommendations for Colorectal Cancer Screening Among Average-Risk Individuals: An Ecobiosocial Approach. Risk Manag Healthc Policy 2022; 15:1025-1043. [PMID: 35599752 PMCID: PMC9115807 DOI: 10.2147/rmhp.s359450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 05/01/2022] [Indexed: 12/09/2022] Open
Abstract
Regardless of the high global burden of colorectal cancer (CRC), the uptake of CRC screening varies across countries. This systematic review aimed to provide a picture of the disparities in recommendations for CRC screening in average-risk individuals using an ecobiosocial approach. It was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was conducted through Scopus, Web of Science, PubMed, and EBSCOHost. Full-text guidelines which were published between 2011 and 2021, along with guidelines which provided recommendations on CRC screening in average-risk individuals, were included in the review. However, guidelines focusing only on a single screening modality were excluded. Fourteen guidelines fulfilling the eligibility criteria were retained for the final review and analysis. Quality assessment of each guideline was performed using the AGREE II instrument. Disparities in guidelines identified in this review were classified into ecological (screening modalities and strategies), biological (recommended age, gender and ethnicities), and social (smoking history, socioeconomic status, and behavior) factors. In general, unstandardized practices in CRC screening for average-risk individuals are likely attributable to the inconsistent and non-specific recommendations in the literature. This review calls on stakeholders and policymakers to review the existing colorectal cancer screening practices and pursue standardization.
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Affiliation(s)
| | - Azmawati Mohammed Nawi
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Mohd Rizal Abdul Manaf
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Huan-Keat Chan
- Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar, 05400, Kedah, Malaysia
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Taylor LC, Kerrison RS, Herrmann B, Stoffel ST. Effectiveness of behavioural economics-based interventions to improve colorectal cancer screening participation: A rapid systematic review of randomised controlled trials. Prev Med Rep 2022; 26:101747. [PMID: 35284211 PMCID: PMC8914541 DOI: 10.1016/j.pmedr.2022.101747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/18/2022] [Accepted: 02/26/2022] [Indexed: 12/22/2022] Open
Abstract
We searched PubMed, PsycInfo and EconLit for RCTs that evaluated BE interventions in CRC screening. We identified 1027 papers for title and abstract review. 30 studies were eligible for the review. The most frequently tested BE intervention was incentives, followed by default principle and salience. Default-based interventions were most likely to be effective. Incentives had mixed evidence. BE remains a promising field of interest in relation to influencing CRC screening behaviours.
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Affiliation(s)
- Lily C. Taylor
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Robert S. Kerrison
- Research Department of Behavioural Science and Health, University College London, London, UK
- School of Health Sciences, University of Surrey, Surrey, UK
| | | | - Sandro T. Stoffel
- Research Department of Behavioural Science and Health, University College London, London, UK
- European Commission, Joint Research Centre (JRC), Ispra, Italy
- Institute for Pharmaceutical Medicine, University of Basel, Basel, Switzerland
- Corresponding author at: Research Department of Behavioural Science and Health, University College London, London, UK.
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Lim TZ, Lau J, Wong GJ, Tan LYT, Chang YJ, Natarajan K, Yi H, Wong ML, Tan KK. Factors predicting improved compliance towards colonoscopy in individuals with positive faecal immunochemical test (FIT). Cancer Med 2021; 10:7735-7746. [PMID: 34519182 PMCID: PMC8559494 DOI: 10.1002/cam4.4275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 01/15/2023] Open
Abstract
Objectives Follow‐up colonoscopy after a positive faecal immunochemical test (FIT) in any colorectal cancer (CRC) screening programme is integral. However, many individuals who had a positive FIT declined colonoscopy subsequently. This study aims to uncover the predictors on completion of colonoscopy using the Health Belief Model (HBM) between individuals who complete and those who did not after a positive FIT. Methods A mixed‐method study comprising qualitative semi‐structured interviews followed by a locally validated questionnaire in Singapore was prospectively administered via telephone interview to average risk individuals with positive FIT results from a cohort of the national FIT screening database referred for follow‐up colonoscopic evaluation. Results A total of 394 individuals, with a median age of 66 years (range, 46–89 years), were recruited. Fifty percent completed follow‐up colonoscopic evaluation and formed the “doers” group. All participants demonstrated high knowledge of symptoms of CRC and awareness and qualitative responses were aligned to the various HBM domains. Using multi‐variable analysis, doers felt that medical recommendations (odds ratio [OR], 2.39, 95% confidence interval [CI]: 1.23–4.63, p = 0.01) and mainstream media publicity (OR, 2.16, 95% CI: 1.09–4.26, p = 0.026) were important. Non‐doers showed positive association with perceived barriers such as cost (OR, 2.15, 95% CI: 1.10–4.20, p = 0.026) and inconvenience (OR, 3.44, 95% CI: 1.50–7.89, p = 0.004). Conclusions Identified factors such as tackling perceived barriers, public health education and active promotion by medical physicians, family and friends could help guide subsequent interventions to improve compliance of individuals with positive FIT to undergo follow‐up colonoscopy. Only a third of FIT‐positive individuals go for follow‐up colonoscopy in Singapore. This is an Asian study comparing knowledge and attitudes of compliant and non‐compliant FIT‐positive individuals towards follow‐up colonoscopy.
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Affiliation(s)
- Tian-Zhi Lim
- Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore
| | - Jerrald Lau
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Gretel Jianlin Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Lavine Yen-Ting Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yu-Jing Chang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Karthiga Natarajan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Mee-Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ker-Kan Tan
- Division of Colorectal Surgery, University Surgical Cluster, National University Health System, Singapore.,Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Tran BT, Choi KS, Sohn DK, Kim SY, Suh JK, Tran TH, Nguyen TTB, Oh JK. Estimating cost-effectiveness of screening for colorectal cancer in Vietnam. Expert Rev Pharmacoecon Outcomes Res 2021; 21:1-10. [PMID: 34129408 DOI: 10.1080/14737167.2021.1940963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/07/2021] [Indexed: 01/22/2023]
Abstract
Background:Presently, there are no national screening programs for cancer in Vietnam. This study aimed to analyze the cost-effectiveness of an annual colorectal cancer (CRC) screening program from the healthcare service provider's perspective for the Vietnamese population.Methods:The economic model consisted of adecision tree and aMarkov model. Adecision tree was constructed for comparing two strategies, including ascreening group with aguaiac-based fecal occult blood test (gFOBT) and ano-screening group in general populations, aged 50 years and above. The Markov model projected outcomes over a25-year horizon. The cost-effectiveness outcome was the incremental cost-effectiveness ratio (ICER) represented by costs per quality-adjusted life-years (QALYs).Results:When compared with no screening, ICER was $1,388per QALY with an increased cost of $ 43.98 and again of 0.032 QALY (Willingness to pay $2,590). The uptake rate of gFOBT, cost of colonoscopy, and the total cost of screening contributed to the largest impact on the ICER. PSA showed that results were robust to variation in parameter estimates, with annual screening remaining cost-effective compared with no screening.Conclusion:Our screening strategy could be considered cost-effective compared to ano screening strategy. Our findings could be potentially used to develop aCRC national screening program.
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Affiliation(s)
- Binh Thang Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Kui Son Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- National Cancer Control Institute; National Cancer Center, Goyang, Republic of Korea
| | - Dae Kyung Sohn
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Jae Kyung Suh
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Thanh Huong Tran
- National Cancer Institute, National Oncology Hospital, Hanoi, Vietnam
| | - Thi Thanh Binh Nguyen
- Department of Pediatrics, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
- Division of Cancer Prevention & Early Detection, National Cancer Center, Goyang, Republic of Korea
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7
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Cheng WC, Chen PJ, Kang JW, Chen WY, Sheu BS. Age, male sex, smoking and metabolic syndrome as risk factors of advanced colorectal neoplasia for fecal immunochemical test negative patients. J Formos Med Assoc 2021; 121:402-408. [PMID: 34127350 DOI: 10.1016/j.jfma.2021.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/02/2021] [Accepted: 05/23/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Fecal immunochemical test (FIT) is worldwide strategy for colorectal cancer screening. The subjects with negative FIT still have the risk of an advanced colorectal neoplasia (AN), including adenoma with villous histology, high grade dysplasia or larger than 1 cm in size, or adenocarcinoma. The study determined the risk factors associated with AN in FIT-negative subjects. METHODS The study included asymptomatic subjects who received health checkup colonoscopy and have provided FIT study within 6 months prior to colonoscopy. The risk factors to have AN in cases with negative FIT were analyzed. The numbers of colonoscopies needed to detect one AN were calculated for the subjects with different risk factors. RESULTS There were 1411 cases, 85 with positive FIT and 1326 with negative FIT within 6 months before colonoscopy. In FIT positive and FIT negative cases, 45.9% and 34.6% were found to have colorectal adenoma, while 20.2% and 4.6% had AN, respectively. The univariate and multivariate logistic regression analyses showed that age more than 50 years old, male sex, smoking history and metabolic syndrome were the significant risk factors to have AN in the FIT negative cases. For cases with negative FIT to have these risk factors, the number of colonoscopies needed to detect one AN was 3.7, lower than 4.5 of the cases with positive FIT. CONCLUSION For the cases with negative FIT, colonoscopy screening should be considered for those male patients over 50 years old, with a history of smoking and metabolic syndrome to detect AN.
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Affiliation(s)
- Wei-Chun Cheng
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Gastroenterology Department, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Po-Jun Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Wen Kang
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ying Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bor-Shyang Sheu
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Xu X, Wu Y, Yi K, Hu Y, Ding W, Xing C. IRF1 regulates the progression of colorectal cancer via interferon‑induced proteins. Int J Mol Med 2021; 47:104. [PMID: 33907823 PMCID: PMC8054637 DOI: 10.3892/ijmm.2021.4937] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/17/2021] [Indexed: 12/21/2022] Open
Abstract
Radiation is one of the main methods for the treatment of colorectal cancer (CRC) before or after surgery. However, radiotherapy tolerance of patients with CRC is often a major concern. Interferon regulatory factor 1 (IRF1) is a member of the IRF family and is involved in the development of multiple diseases, including tumors. The present study investigated the role of IRF1 in the development and radiation sensitivity of CRC. Immunohistochemistry was performed to examine the expression levels of IRF1 in tissue samples from patients with CRC, as well as in nude mice. MTT, 5‑ethynyl‑20‑deoxyuridine, colony formation, cell cycle alteration and apoptosis assays were performed in CRC cell lines. Western blotting and immunofluorescence were used to detect the expression levels of a series of proteins. RNA sequencing was applied to identify genes whose expression was upregulated by IRF1 overexpression. Xenograft nude mouse models and hematoxylin and eosin staining were used to validate the present findings in vivo. It was revealed that the expression levels of IRF1 were significantly lower in CRC tissues than in adjacent tissues. IRF1 upregulation inhibited cell proliferation and colony formation, caused G1 cell arrest, promoted cell apoptosis, and enhanced the sensitivity of CRC cells to X‑ray irradiation. The role of IRF1 in promoting the radiosensitivity of CRC was further demonstrated in nude mice with CRC xenografts. In addition, RNA sequencing revealed that overexpression of IRF1 in CRC cells significantly increased the expression levels of interferon‑induced protein family members interferon α inducible protein 6, interferon induced transmembrane protein 1 and interferon induced protein 35 (fold change >2.0). In summary, the present study demonstrated that the upregulation of IRF1 inhibited the progression and promoted the radiosensitivity of CRC, likely by regulating interferon‑induced proteins.
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Affiliation(s)
- Xiaohui Xu
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
- Department of General Surgery, The First People's Hospital of Taicang, Taicang Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215400, P.R. China
- Central Laboratory, The First People's Hospital of Taicang, Taicang Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215400, P.R. China
- Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Yong Wu
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
| | - Ke Yi
- Central Laboratory, The First People's Hospital of Taicang, Taicang Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215400, P.R. China
| | - Yan Hu
- Central Laboratory, The First People's Hospital of Taicang, Taicang Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215400, P.R. China
| | - Weiqun Ding
- Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
| | - Chungen Xing
- Department of General Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
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Oh CK, Aniwan S, Piyachaturawat P, Wong Z, Soe T, Luvsandagva B, Tran QT, Fauzi A, Byeon JS, Cho YS. Adherence to Surveillance Guidelines after the Removal of Colorectal Polyps: A Multinational, Multicenter, Prospective Survey. Gut Liver 2021; 15:878-886. [PMID: 33790055 PMCID: PMC8593505 DOI: 10.5009/gnl20166] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 12/31/2020] [Accepted: 01/06/2021] [Indexed: 12/24/2022] Open
Abstract
Background/Aims As the number of colonoscopies and polypectomies performed continues to increase in many Asian countries, there is a great demand for surveillance colonoscopy. The aim of this study was to investigate the adherence to postpolypectomy surveillance guidelines among physicians in Asia. Methods A survey study was performed in seven Asian countries. An email invitation with a link to the survey was sent to participants who were asked to complete the questionnaire consisting of eight clinical scenarios. Results Of the 137 doctors invited, 123 (89.8%) provided valid responses. Approximately 50% of the participants adhered to the guidelines regardless of the risk of adenoma, except in the case of tubulovillous adenoma ≥10 mm combined with high-grade dysplasia, in which 35% of the participants adhered to the guidelines. The participants were stratified according to the number of colonoscopies performed ≥20 colonoscopies per month (high volume group) and <20 colonoscopies per month (low volume group). Higher adherence to the postpolypectomy surveillance guidelines was evident in the high volume group (60%) than in the low volume group (25%). The reasons for nonadherence included concern of missed polyps (59%), the low cost of colonoscopy (26%), concern of incomplete resection (25%), and concern of medical liability (15%). Conclusions A discrepancy between clinical practice and surveillance guidelines among physicians in Asia was found. Physicians in the low volume group frequently did not adhere to the guidelines, suggesting a need for continuing education and appropriate control. Concerns regarding the quality of colonoscopy and complete polypectomy were the main reasons for nonadherence.
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Affiliation(s)
- Chang Kyo Oh
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Satimai Aniwan
- Deprtment of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Panida Piyachaturawat
- Deprtment of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Zhiqin Wong
- Gastroentorology Unit, Department of Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Thida Soe
- Department of Gastroenterology, University of Medicine 1 Yangon, Yangon, Myanmar
| | | | - Quang Trung Tran
- Department of Internal Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.,Department of Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Achmad Fauzi
- Department of Internal Medicine, University of Indonesia, Kota Depok, Indonesia
| | - Jeong-Sik Byeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Seok Cho
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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10
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Li S, Huang J, Qin M, Zhang J, Liao C. High expression of CDCA7 predicts tumor progression and poor prognosis in human colorectal cancer. Mol Med Rep 2020; 22:57-66. [PMID: 32319649 PMCID: PMC7248471 DOI: 10.3892/mmr.2020.11089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 02/07/2020] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer (CRC) is one of the most fatal types of cancer worldwide. This study aimed to determine the predictive and prognostic values of cell division cycle associated protein 7 (CDCA7) in CRC. Firstly, the relationship between CDCA7 and CRC was assessed through bioinformatics analysis. Subsequently, CDCA7 expression levels were detected in various CRC cell lines, as well as 15 fresh human CRC tissues and their paired adjacent normal colorectal tissues using reverse transcription‑quantitative PCR and western blotting. Additionally, immunohistochemical staining was used to determine the levels of CDCA7 in 104 CRC tissues and their paired adjacent normal colorectal tissues. The present study revealed that CDCA7 expression was upregulated in CRC tissues and cell lines. The positive expression rates of CDCA7 in normal and CRC tissues were 26.92 and 75.96%, respectively. The intensities of CDCA7 immunostaining were significantly associated with CRC invasion depth, lymph node metastasis, tumor‑node‑metastasis stage and distant metastasis. However, no significant differences in sex, age, tumor size and CRC differentiation were found between high and low CDCA7 expression groups. Furthermore, patients with low CDCA7 expression exhibited a greater overall survival rate of CRC compared to those with high CDCA7 expression. The findings of this study indicated that CDCA7 may serve a significant role in CRC prognosis and progression, and may be considered a novel biomarker for the prediction of patient survival after colectomy.
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Affiliation(s)
- Siman Li
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
| | - Jiean Huang
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, P.R. China
| | - Mengbin Qin
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, P.R. China
| | - Jinxiu Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, P.R. China
| | - Cun Liao
- Department of Colorectal-Anal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China
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Kuo CN, Liao YM, Kuo LN, Tsai HJ, Chang WC, Yen Y. Cancers in Taiwan: Practical insight from epidemiology, treatments, biomarkers, and cost. J Formos Med Assoc 2019; 119:1731-1741. [PMID: 31522970 DOI: 10.1016/j.jfma.2019.08.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 07/25/2019] [Accepted: 08/23/2019] [Indexed: 12/20/2022] Open
Abstract
Cancer is the leading cause of death in Taiwan, and the overall incidence rate has gradually increased. The four most common cancers in Taiwan are colorectal, lung, breast and liver cancers. With the rise in incidence, the clinical use and costs of all anticancer drugs have steadily increased. The costs of novel therapeutics, such as targeted therapies and immunotherapy were accounted almost two-third of all antineoplastic agents in Taiwan. Moving forward, it will be necessary to discuss the economic impacts to clinical use of new therapeutics, while continuing to monitor and improve the quality of cancer therapy. In this review, we describe the epidemiology, disease screening policies and medication treatment policies for colorectal, lung, breast and liver cancer. We focus on the recent developments in cancer therapeutics, discuss the use of biomarkers, and finally consider the costs and the recent advances of anticancer medications in Taiwan.
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Affiliation(s)
- Chun-Nan Kuo
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Ming Liao
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Li-Na Kuo
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Wei-Chiao Chang
- Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Integrative Research Center for Critical Care, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Yun Yen
- The PhD Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
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12
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Li X, Zhou Y, Luo Z, Gu Y, Chen Y, Yang C, Wang J, Xiao S, Sun Q, Qian M, Zhao G. The impact of screening on the survival of colorectal cancer in Shanghai, China: a population based study. BMC Public Health 2019; 19:1016. [PMID: 31357981 PMCID: PMC6664771 DOI: 10.1186/s12889-019-7318-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 07/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background Shanghai is one of the earliest cities in developing countries to introduce an organized colorectal screening program for its residents to fight against the rising disease burden of colorectal cancer (CRC). This study aims to investigate the impact of the Shanghai screening program implemented in 2013 on the survival rates of CRC patients. Methods We calculated up to 5-year survival rates for 18,592 CRC patients from a representative district of Shanghai during 2002–2016, using data from the Shanghai Cancer Registry. We performed joinpoint regressions to examine temporal changes in the trends of the CRC survival rates. We then conducted Kaplan-Meier and Cox proportional hazards modelling to study the association of the survival rates with screening behaviors of the patients. In all the model specifications, we took into account the gender, age and TNM stage at diagnosis, and level of treatment hospital of the patients. Results We find that the annual percentage changes of the survival rates increased faster after somewhere around 2013, however, the differential trends were not significant. Results from the Cox multivariate regression analysis suggest that patients who did not participate in the screening program showed significantly lower cancer-specific survival (hazard ratio (HR) = 1.46; 95% confidence interval (CI): 1.12–1.91) and all-causes survival (HR = 1.37; 95% CI: 1.05–1.77), compared to those who did. Among program participants, delayed colonoscopy was associated with poor cancer-specific survival (hazard ratio (HR) = 2.93; 95% confidence interval (CI): 1.64–5.23) and all-causes survival (HR = 3.29; 95% CI: 1.85–5.84). Conclusion Screening participation and high level of colonoscopy compliance can improve the survival of CRC participants. Electronic supplementary material The online version of this article (10.1186/s12889-019-7318-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaopan Li
- School of Public Health, Fudan University, 130 Dong'an Rd, Shanghai, 200032, China.,Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Yi Zhou
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Zheng Luo
- Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Pudong New Area, Shanghai, 201318, China
| | - Yi'an Gu
- Department of epidemiology, Columbia University, New York, NY, USA
| | - Yichen Chen
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Chen Yang
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Jing Wang
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Shaotan Xiao
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Qiao Sun
- Center for Disease Control and Prevention, Pudong New Area, Shanghai, 200136, China.,Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai, 200136, China
| | - Mengcen Qian
- School of Public Health, Fudan University, 130 Dong'an Rd, Shanghai, 200032, China.
| | - Genming Zhao
- School of Public Health, Fudan University, 130 Dong'an Rd, Shanghai, 200032, China. .,The Key Laboratory of Public Health and Safety of Education Ministry, Fudan University, 138 Yixueyuan Rd, Shanghai, 200032, China.
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13
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Onyoh EF, Hsu WF, Chang LC, Lee YC, Wu MS, Chiu HM. The Rise of Colorectal Cancer in Asia: Epidemiology, Screening, and Management. Curr Gastroenterol Rep 2019; 21:36. [PMID: 31289917 DOI: 10.1007/s11894-019-0703-8] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE OF REVIEW Colorectal cancer (CRC) remains the third most commonly diagnosed cancer globally, and its incidence and mortality rates have been on the rise in Asia. In this paper, we summarize the recent trends and screening challenges of CRC in this region. RECENT FINDINGS In 2018, Asia had the highest proportions of both incident (51.8%) and mortality (52.4%) CRC cases (all genders and ages) per 100,000 population in the world. In addition, there has been a rising trend of this disease across Asia with some regional geographic variations. This rise in CRC can be attributed to westernized dietary lifestyle, increasing population aging, smoking, physical inactivity, and other risk factors. In curbing the rising trend, Japan, South Korea, Singapore, and Taiwan have launched nationwide population-based screening programs. CRC screening across this region has been found to be effective and cost-effective compared with no screening at all. The emergence of new therapies has caused a reduction in case fatality; however, these new options have had a limited impact on cure rates and long-term survival due to the great disparity in treatment capacity/resources and screening infrastructures among Asian countries with different degrees of economic development. CRC is still rising in Asia, and implementation of screening is necessary for moderate- to high-incidence countries and construction of treatment capacity is the priority task in low-incidence and low-income countries. Unless countries in Asia implement CRC screening, the incidence and mortality rates of this disease will continue to rise especially with the rapidly rising population growth, economic development, westernized lifestyle, and increasing aging.
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Affiliation(s)
- Elias F Onyoh
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- AIDS Care and Prevention Program, Cameroon Baptist Convention Health Services, Bamenda, Cameroon
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan
| | - Wen-Feng Hsu
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Li-Chun Chang
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Yi-Chia Lee
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan
| | - Han-Mo Chiu
- Taiwanese Colorectal Cancer Screening Program, Taipei, Taiwan.
- Department of Internal Medicine, College of Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan.
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14
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Phimha S, Promthet S, Suwanrungruang K, Chindaprasirt J, Bouphan P, Santong C, Vatanasapt P. Health Insurance and Colorectal Cancer Survival in Khon Kaen, Thailand. Asian Pac J Cancer Prev 2019; 20:1797-1802. [PMID: 31244302 PMCID: PMC7021590 DOI: 10.31557/apjcp.2019.20.6.1797] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/04/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Evidence from healthcare studies demonstrates that patients’ health insurance affects service accessibility and the outcome of treatment. However, assessment on how colorectal cancer survival relates to health insurance is limited. Objective: The study examined the association between health insurance and colorectal cancer survival in Khon Kaen, Thailand. Methods: The retrospective cohort study was conducted with 1,931 colorectal cancer patients from Khon Kaen cancer registry between January 1, 2003 and December 31, 2012, and was followed-up until December 31, 2015. Relative survival was used to estimate the survival rate. Cox proportional hazard regression was used to estimate the relationship between health insurance and colorectal cancer survival, represented with the hazard ratio. Result: Most of the participants were males, and the median age was 62 years. The median survival time was 2.25 years (95% CI: 2.00-2.51). The five-year observed survival rate and relative survival rate were 36.87 (95% CI: 34.66-39.08) and, 42.28 (95% CI: 39.75-44.81), respectively. The factors that showed significant associations with poorer survival after adjustment for gender and age were non-surgical treatments (HRadj=1.88;95%CI=1.45-2.45), advanced stage (III+IV) (HRadj=2.50; 95%CI=2.00-3.12), histological grading in poorly differentiated (HRadj=1.84; 95%CI=1.32-2.56), and Universal Coverage Scheme (HRadj=1.37;95%CI=1.09-1.72). Conclusion: The survival of colorectal cancer patients in the Universal Coverage Scheme was likely to be poorer than in the Civil Servant Medical Benefit Scheme. This indicates an urgent need for a national program for colorectal cancer screening in the general population and access to health insurance.
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Affiliation(s)
- Surachai Phimha
- Doctor of Philosophy Program in Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.
| | - Supannee Promthet
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.
| | - Krittika Suwanrungruang
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.
- Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jarin Chindaprasirt
- Division of Oncology, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Prachak Bouphan
- Department of Public Health Administration Health Promotion Nutrition, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand
| | - Chalongpon Santong
- Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Patravoot Vatanasapt
- ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Khon Kaen, Thailand.
- Cancer Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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15
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Sano Y, Chiu H, Li X, Khomvilai S, Pisespongsa P, Co JT, Kawamura T, Kobayashi N, Tanaka S, Hewett DG, Takeuchi Y, Imai K, Utsumi T, Teramoto A, Hirata D, Iwatate M, Singh R, Ng SC, Ho S, Chiu P, Tajiri H. Standards of diagnostic colonoscopy for early-stage neoplasia: Recommendations by an Asian private group. Dig Endosc 2019; 31:227-244. [PMID: 30589103 PMCID: PMC6850515 DOI: 10.1111/den.13330] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/24/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM In recent years, the incidence of colorectal cancer has been increasing, and it is now becoming the major cause of cancer death in Asian countries. The aim of the present study was to develop Asian expert-based consensus to standardize the preparation, detection and characterization for the diagnosis of early-stage colorectal neoplasia. METHODS A professional group was formed by 36 experts of the Asian Novel Bio-Imaging and Intervention Group (ANBI2 G) members. Representatives from 12 Asia-Pacific countries participated in the meeting. The group organized three consensus meetings focusing on diagnostic endoscopy for gastrointestinal neoplasia. The Delphi method was used to develop the consensus statements. RESULTS Through the three consensus meetings with debating, reviewing the literature and regional data, a consensus was reached at third meeting in 2016. The consensus was reached on a total of 10 statements. Summary of statements is as follows: (i) Adequate bowel preparation for high-quality colonoscopy; (ii) Antispasmodic agents for lesion detection; (iii) Image-enhanced endoscopy (IEE) for polyp detection; (iv) Adenoma detection rate for quality indicators; (v) Good documentation of colonoscopy findings; (vi) Complication rates; (vii) Cecal intubation rate; (viii) Cap-assisted colonoscopy (CAC) for polyp detection; (ix) Macroscopic classification using indigocarmine spray for characterization of colorectal lesions; and (x) IEE and/or magnifying endoscopy for prediction of histology. CONCLUSION This consensus provides guidance for carrying out endoscopic diagnosis and characterization for early-stage colorectal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early-stage colorectal neoplasia.
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Affiliation(s)
- Yasushi Sano
- Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC)Sano HospitalHyogo
| | - Han‐Mo Chiu
- Department of Internal MedicineCollege of MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Xiao‐bo Li
- Division of Gastroenterology and HepatologyKey Laboratory of Gastroenterology and HepatologyMinistry of HealthRenji HospitalSchool of MedicineShanghai Institute of Digestive DiseaseShanghai Jiao Tong UniversityShanghaiChina
| | - Supakij Khomvilai
- Surgical EndoscopyColorectal SurgeryDepartment of SurgeryChulalongkorn UniversityBangkokThailand
| | - Pises Pisespongsa
- Digestive Disease CenterBumrungrad International HospitalBangkokThailand
| | - Jonard Tan Co
- St. Luke's Medical Centre ‐ Global CityTaguig City, Metro ManilaPhilippines
| | - Takuji Kawamura
- Department of GastroenterologyKyoto Second Red Cross HospitalKyotoJapan
| | | | - Shinji Tanaka
- Department of EndoscopyHiroshima University HospitalHiroshimaJapan
| | - David G. Hewett
- Faculty of MedicineUniversity of QueenslandBrisbaneAustralia
| | - Yoji Takeuchi
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Kenichiro Imai
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | - Takahiro Utsumi
- Department of Gastroenterology and HepatologyKyoto University Graduate School of MedicineKyotoJapan
| | - Akira Teramoto
- Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC)Sano HospitalHyogo
| | - Daizen Hirata
- Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC)Sano HospitalHyogo
| | - Mineo Iwatate
- Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC)Sano HospitalHyogo
| | - Rajvinder Singh
- Gastroenterology UnitDivision of MedicineLyell McEwin HospitalSchool of MedicineThe University of AdelaideAdelaideAustralia
| | - Siew C. Ng
- Departments of Medicine and TherapeuticsInstitute of Digestive DiseaseState Key Laboratory of Digestive DiseasesLKS Institute of Health ScienceThe Chinese University of Hong KongHong KongChina
| | - Shiaw‐Hooi Ho
- Department of MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Philip Chiu
- SurgeryInstitute of Digestive DiseaseState Key Laboratory of Digestive DiseasesLKS Institute of Health ScienceThe Chinese University of Hong KongHong KongChina
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy ResearchThe Jikei University School of MedicineTokyoJapan
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16
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Young GP, Rabeneck L, Winawer SJ. The Global Paradigm Shift in Screening for Colorectal Cancer. Gastroenterology 2019; 156:843-851.e2. [PMID: 30776340 DOI: 10.1053/j.gastro.2019.02.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Graeme P Young
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, Australia
| | - Linda Rabeneck
- Cancer Care Ontario and, University of Toronto, Toronto, Ontario, Canada
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17
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Yuan SY, Wu W, Fu J, Lang YX, Li JC, Guo Y, Wang YN, Qian JM, Li JN. Quantitative immunochemical fecal occult blood test for neoplasia in colon cancer screening. J Dig Dis 2019; 20:78-82. [PMID: 30714346 DOI: 10.1111/1751-2980.12711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/26/2018] [Accepted: 01/29/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the performance of the quantitative immunochemical fecal occult blood test (qFIT) and to determine the association between the fecal hemoglobin (Hb) level and the location and size of adenomas and the stages of colorectal cancer (CRC). METHODS A total of 692 participants were included in the study. Their fecal Hb level was measured using an OC-SENSA MICRO qFIT. The colonoscopy results, including the location, size, and histological features of the adenomas, as well as the relationship between the Hb level and different characteristics were analyzed. Performance of the qFIT at various thresholds of fecal Hb levels was evaluated. RESULTS Advanced colorectal neoplasia (ACRN) was identified in 76 patients based on the colonoscopic and pathological examinations. Large adenomas (≥10 mm) had a higher fecal Hb level than small adenomas (<10 mm). Advanced adenomas located on the left side of the colon presented with a higher fecal Hb level than those on the right side (P = 0.022). Stage III-IV CRC patients had a significantly higher Hb level than stage I-II patients (P = 0.013). The sensitivity and specificity of qFIT for ACRN was 51.3% and 86.4%,respectively, with the best cut-off level of 400 ng/mL. The sensitivity and specificity for CRC was 61.0% and 89.1%, with the best cut-off level of 500 ng/mL. CONCLUSIONS qFIT has an acceptable sensitivity and specificity for ACRN detection. Furthermore, the qFIT results are associated with the location and size of adenomas as well as the grade of CRC.
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Affiliation(s)
- Si Yi Yuan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Wu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Fu
- Medical Examination Center, Panjinliaoyou Gem Flower Hospital, Panjin, Liaoning Province, China
| | - Yi Xuan Lang
- The Fourth Hospital of Jilin University (FAW General Hospital), Changchun, Jilin Province, China
| | - Ji Chi Li
- Department of Oncological Surgery, Panjinliaoyou Gem Flower Hospital, Panjin, Liaoning Province, China
| | - Ye Guo
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ya Nan Wang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jia Ming Qian
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Nan Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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18
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Li X, Qian M, Zhao G, Yang C, Bao P, Chen Y, Zhou X, Yan B, Wang Y, Zhang J, Sun Q. The performance of a community-based colorectal cancer screening program: Evidence from Shanghai Pudong New Area, China. Prev Med 2019; 118:243-250. [PMID: 30412744 DOI: 10.1016/j.ypmed.2018.11.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 10/23/2018] [Accepted: 11/01/2018] [Indexed: 12/28/2022]
Abstract
Despite the rising disease burden of colorectal cancer (CRC), CRC screening has not yet been widely introduced as a large organized program in developing countries. To facilitate better delivery of screening in these areas, we investigated the performance of a large community-based CRC screening program implemented in Shanghai Pudong New Area during the period 2013-2016. We conducted a prospective cohort study by following up the screening behavior and results of tested participants in the program. Data from the program reporting system and monthly progress reports were collected. We used standard measures and indicators with modifications to evaluate the performance of the program. Disparities in CRC screening by age categories, primary screening results, and geographic areas were examined. A total of 403,098 individuals participated in the program, 25,764 of them were further screened by diagnostic colonoscopy (COL), and 505 people were eventually diagnosed with CRC as a result of the program. The program produced the following rates: participation (35.18%), primary screening positivity (24.89%), positive primary screening follow-up (26.26%), diagnostic COL (6.37%), and cancer detection (1.25‰). Vast variations in the quality of the program were observed across areas with different socioeconomic environments. The experience and lessons from the program suggest that incorporating the screening with other public health campaigns, using better-developed risk assessment tools, and allowing individual screening decisions for those aged above the target are possible practical ways to promote a better delivery of organized CRC screening programs.
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Affiliation(s)
- Xiaopan Li
- School of Public Health, Fudan University, Shanghai 200032, China; Center for Disease Control and Prevention, Pudong New Area, Shanghai 200136, China; Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai 200136, China
| | - Mengcen Qian
- School of Public Health, Fudan University, Shanghai 200032, China; Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai 200136, China
| | - Genming Zhao
- School of Public Health, Fudan University, Shanghai 200032, China.
| | - Chen Yang
- Center for Disease Control and Prevention, Pudong New Area, Shanghai 200136, China; Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai 200136, China
| | - Pingping Bao
- Center for Disease Control and Prevention, Shanghai 200336, China
| | - Yichen Chen
- School of Public Health, Fudan University, Shanghai 200032, China; Center for Disease Control and Prevention, Pudong New Area, Shanghai 200136, China; Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai 200136, China
| | - Xiaoyan Zhou
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Bei Yan
- Center for Disease Control and Prevention, Pudong New Area, Shanghai 200136, China; Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai 200136, China
| | - Yingying Wang
- Center for Disease Control and Prevention, Pudong New Area, Shanghai 200136, China; Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai 200136, China
| | - Jun Zhang
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Qiao Sun
- Center for Disease Control and Prevention, Pudong New Area, Shanghai 200136, China; Fudan University Pudong Institute of Preventive Medicine, Pudong New Area, Shanghai 200136, China
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