Acceptability of alternative technologies compared with faecal immunochemical test and/or colonoscopy in colorectal cancer screening: A systematic review

Perceptions of the Impact of Comorbidity on the Bowel Cancer Screening Programme: Qualitative Study With Bowel Screening Participants and Staff

INTRODUCTION

The impact of multiple health conditions on bowel cancer screening is currently unknown. We explored the impact of multiple health conditions on bowel cancer screening perceptions, experience and clinical management decisions following a positive stool test.

METHODS

Semi-structured qualitative interviews were conducted remotely with Bowel Screening Wales staff (n = 16) stratified by regional location and role and with screening participants (n = 19) stratified by age, gender and comorbidity. Interview topics were guided by the Common-Sense Model.

RESULTS

Screening participants, regardless of comorbidity status, placed great emphasis on the importance of early detection of cancer and completing the bowel screening process. Screening staff emphasised comorbidities in the clinical decision-making process; however, screening participants had low awareness of the impact that comorbidities can have on bowel screening. Participants describe how the presence of multiple health conditions can mask potential bowel symptoms and influence beliefs about follow-up.

CONCLUSION

Bowel screening staff try to individualise the service to meet participant needs. The potential mismatch in screening staff and participant awareness and expectations of the bowel screening and diagnostic process needs to be addressed. Clearer and more regular communication with screening participants could support the screening process, particularly for those with significant coexisting health conditions or facing time delays. The possible masking effects and misattribution of symptoms because of comorbidities highlight an opportunity for education and raising awareness for screening participants and a potential area of focus for discussions in clinical consultations and staff training.

PATIENT AND PUBLIC CONTRIBUTION

Project funding included costs for patients and public contributors to be compensated for their contributions to the project, in line with current standards. A patient and public contributor was involved in the design of the study, including protocol development, and the interpretation of key findings and implications for patients, which are subsequently reflected within the manuscript.

Predictors of stool deoxyribonucleic acid test use in the United States: Implications for outreach to under-resourced populations

OBJECTIVE

Although colorectal cancer screening (CRCS) is a public health priority, uptake is suboptimal in under-resourced groups. Noninvasive modalities, including stool deoxyribonucleic acid (sDNA) testing, may mitigate economic, geographic, cultural, or impairment-related barriers to CRCS. We assessed use of sDNA testing and other CRCS modalities in U.S. residents, comparing subgroups defined by several social determinants of health (SDOH).

METHODS

A nationally representative sample of community-dwelling respondents aged 50-75 years self-reported use of CRCS modalities in the 2020 Behavioral Risk Factor Surveillance System Survey. Statistical analyses assessed up-to-date screening status and choice of modality in the recommended screening interval.

RESULTS

Of 179,833 sampled respondents, 60.8% reported colonoscopy, 5.7% sDNA testing, 5.5% another modality. The rate of up-to-date screening was 72.0% overall and negatively associated with Hispanic ethnicity (63.6%), lower educational and annual income levels (e.g.,

CONCLUSIONS

Under-resourced persons were more likely than better-resourced persons to access sDNA testing, possibly offsetting screening barriers in some groups. Findings suggest opportunities to increase CRCS with heightened communication about sDNA testing to those who may experience difficulty accessing other modalities.

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Key Words

• Behavioral Risk Factor Surveillance System
• Cancer screening
• Colonoscopy
• Colorectal cancer
• Colorectal cancer screening
• Health disparities
• Social determinants of health
• Stool deoxyribonucleic acid

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MESH Headings

• Humans
• Male
• Middle Aged
• Female
• Aged
• United States
• Feces/chemistry
• Colorectal Neoplasms/diagnosis
• Early Detection of Cancer/statistics & numerical data
• Behavioral Risk Factor Surveillance System
• DNA/analysis
• Colonoscopy/statistics & numerical data
• Mass Screening/statistics & numerical data
• Social Determinants of Health

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Affiliation(s)

Kathleen A Fairman Midwestern University College of Pharmacy, Glendale Campus, 19555 North 59(th) Avenue, Glendale, AZ 85308, United States of America.
Sarah T Lira Veterinary Pharmacy Resident, University of Illinois Urbana-Champaign, At the time the research was conducted, Dr. Lira was a PharmD student at the Midwestern University College of Pharmacy, Glendale Campus., 1008 West Hazelwood Drive, Urbana, IL 61802, United States of America.

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Roles of circRNAs in the progression of colorectal cancer: novel strategies for detection and therapy

Endogenous noncoding RNAs with a covalently closed loop are known as circular RNAs (circRNAs). Recently, published works have revealed that circRNAs, which act as microRNA sponges, are critical for the biological behavior of several kinds of malignancies, including tumor cell proliferation, apoptosis, invasion, and metastasis. Additionally, there is a significant correlation between circRNAs and tumor resistance, stage, prognosis, and size. At present, colorectal cancer (CRC) is one of the most serious malignant tumors for human health. CircRNAs could represent potential targets to use in the prevention, diagnosis, and therapy of CRC, according to many studies. To fully comprehend the role of circRNAs in the incidence and progression of CRC, this review outlines the regulatory role and mechanisms of circRNAs in CRC and assesses their potential relevance as diagnostic and treatment possibilities for CRC. Our goal is to offer meaningful biological information for clinical evaluation and decision-making process for CRC treatment.

Colorectal Cancer: Epidemiology, Risk Factors, and Prevention

Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer mortality worldwide. There are disparities in the epidemiology of CRC across different populations, most probably due to differences in exposure to lifestyle and environmental factors related to CRC. Prevention is the most effective method for controlling CRC. Primary prevention includes determining and avoiding modifiable risk factors (e.g., alcohol consumption, smoking, and dietary factors) as well as increasing protective factors (e.g., physical activity, aspirin). Further studies, especially randomized, controlled trials, are needed to clarify the association between CRC incidence and exposure to different risk factors or protective factors. Detection and removal of precancerous colorectal lesions is also an effective strategy for controlling CRC. Multiple factors, both at the individual and community levels (e.g., patient preferences, availability of screening modalities, costs, benefits, and adverse events), should be taken into account in designing and implementing CRC screening programs. Health policymakers should consider the best decision in identifying the starting age and selection of the most effective screening strategies for the target population. This review aims to present updated evidence on the epidemiology, risk factors, and prevention of CRC.