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Hortalà C, Selva C, Sola I, Selva A. Experience and satisfaction of participants in colorectal cancer screening programs: a qualitative evidence synthesis. BMC Public Health 2024; 24:2293. [PMID: 39180046 PMCID: PMC11342476 DOI: 10.1186/s12889-024-19678-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 08/02/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Experience and satisfaction of colorectal cancer screening program participants are among the key factors that determine adherence to these programs. Understanding them is crucial to ensure future participation. OBJECTIVES To explore and gain understanding on the experience and satisfaction of the average-risk population participating in colorectal cancer screening programs. METHODS A Qualitative Evidence Synthesis. We conducted a literature search up to April 2023 in Medline, Embase, CINAHL, PsycINFO and ProQuest Dissertations and Thesis. We independently selected the studies for their inclusion, assessed their methodological quality (with CASP tool) and extracted data. Disagreements were solved by consensus. We thoroughly read the selected studies, and analyzed the data following a thematic synthesis approach. We evaluated the confidence in our findings with CERQUAL. RESULTS We included six studies: four had an appropriate quality, and two had some methodological limitations. We identified five main findings across studies: (1) Variability in the concerns about the results; (2) Challenges regarding procedure logistics; (3) Care received from the healthcare professionals; (4) Being adequately informed; (5) Expectations and experience with the program. All findings had a moderate level of confidence. CONCLUSIONS Our qualitative review provides a picture of the experience and satisfaction of the average-risk population participating in colorectal cancer screening programs. Despite some logistical and expectation management issues, the overall satisfaction with the programs is high. More research is needed on the topic, as there are still important gaps in knowledge.
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Affiliation(s)
| | - Clara Selva
- Universitat Oberta de Catalunya, Catalonia, Spain
| | - Ivan Sola
- Universitat Autònoma de Barcleona, Catalonia, Spain
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anna Selva
- Universitat Autònoma de Barcleona, Catalonia, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
- Clinical Epidemiology and Cancer Screening, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT_CERCA), Sabadell, Spain.
- Clinical Epidemiology and Cancer Screening, Parc Taulí Hospital Universitari, Parc Taulí, 1, Sabadell, 08208, Spain.
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Nelson K, Carter K, Hepburn J, Hill I, Hurlow C, O'Neill C, Tang A, Harris DA. Patient and healthcare professionals' perceptions of a combined blood and faecal immunochemical test for excluding colorectal cancer diagnosis in primary care. Health Expect 2023; 26:2655-2665. [PMID: 37697688 PMCID: PMC10632655 DOI: 10.1111/hex.13796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVES To explore the perceptions of patients and healthcare professionals on Raman-faecal immunochemical test (FIT) as an alternative test for colorectal cancer exclusion in primary care. DESIGN Semi-structured interviews within a feasibility study. SETTING Patients presenting to primary care with colorectal symptoms and healthcare professionals working in primary and secondary care. PARTICIPANTS A total of 23 patients and 12 healthcare professionals. METHODS Patient participants were asked to complete a novel combined Raman-FIT test before being seen in secondary care. This study sought their opinions about the test. We also sought the views of healthcare professionals. FINDINGS Patients and healthcare professionals agreed that Raman-FIT was a suitable test to be given in primary care. It aligned with routine practice and was a simple test for most patients to complete. CONCLUSIONS Patients are willing and able to complete the Raman-FIT test in primary care. Raman-FIT may accelerate access to diagnosis with the potential to improve cancer outcomes. PATIENT AND PUBLIC INVOLVEMENT Lay members (J. H. and I. H.) with experience and knowledge of colorectal cancer and screening contributed to developing, undertaking, and disseminating all aspects of the research. They were supported to collaborate as equal members of the research team. They were involved in developing the study as coapplicants, using personal experience to ensure that the research and its methods were relevant to the patient and public needs. Both prepared participant information sheets, coanalysed data, and contributed to study reporting and dissemination through papers, conference presentations and a lay summary.
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Affiliation(s)
- Kayleigh Nelson
- Faculty of Medicine, Health and Life SciencesSwansea UniversitySwanseaWales
| | - Kym Carter
- Faculty of Medicine, Health and Life SciencesSwansea UniversitySwanseaWales
| | - Julie Hepburn
- Public Involvement CommunityHealth and Care Research WalesCardiffWales
| | - Ian Hill
- Public Involvement CommunityHealth and Care Research WalesCardiffWales
| | - Claire Hurlow
- Faculty of Medicine, Health and Life SciencesSwansea UniversitySwanseaWales
| | - Claire O'Neill
- Bevan CommissionSwansea University School of ManagementSwanseaWales
| | - Alethea Tang
- Department of Colorectal Surgery, Morriston HospitalSwansea Bay University Health BoardSwanseaWales
| | - Dean A. Harris
- Faculty of Medicine, Health and Life SciencesSwansea UniversitySwanseaWales
- Department of Colorectal Surgery, Morriston HospitalSwansea Bay University Health BoardSwanseaWales
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Shamsutdinova A, Turdaliyeva B, Tanabayeva S, Omarova A, Saliev T, Tanabayev B, Fakhradiyev I. Screening for Breast, Cervical and Prostate Cancers in Kazakhstan: Key Factors and Psychological Aspects. Asian Pac J Cancer Prev 2023; 24:2515-2522. [PMID: 37505786 PMCID: PMC10676473 DOI: 10.31557/apjcp.2023.24.7.2515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Screening is the main method for early detection and reduction of cancer mortality in all countries, including Central Asia and Kazakhstan. However, there is no official data on the awareness of the population about cancer screening in Kazakhstan. In addition, there were no studies on the psycho-emotional state of the patients during the screening procedure conducted yet. The purpose of the study was to assess the potential factors of awareness and psycho-emotional state during screening for breast (BC), cervical (CC), and prostate cancers (PC) in Kazakhstan (using the example of Almaty city). METHODS This cross-sectional study was conducted in the period from 01/01/2017 to 05/31/2017. The study was carried out at six polyclinics in Almaty (Kazakhstan). 1 625 volunteers took part in the study. The special questionnaires were employed to assess awareness of the screening procedure and subjective feelings during screening. The survey was conducted on patients who were screened for BC (n=674 or 41.5%), CC (n=565 or 34.8%) and PC (n=386 or 23.8%). Demographic data (age, education, marital status, preferred language of communication, etc.) were collected from participants using in-depth interviews. The internal consistency of the questionnaires was analysed by determining the reliability index (Cronbach's alpha). RESULTS The mean age of screening participants was 54.6 ± 3.3 years (BC), 49.2 ± 7.3 years (CC), and 56.6 ± 5.1 years (PC) (p = 0.001). Participants in BC and CC screening had a general knowledge of the procedure (45.1 % and 59.8 % of cases, respectively). Men had no information about PC screening (76.4 % of cases, p = 0.001). On the other hand, women had no sufficient knowledge about mammography (46.4 %) and Papanicolaou (Pap) test (51.2% of cases). In 40.1 % (BC) and 41.1 % (CC) of cases, the fact of having the test was an unpleasant circumstance. However, in 59.6 % (PC) of cases, men did not have any discomfort associated with undertaking the test (p = 0.001). PC screening participants experienced no discomfort in 58.3 % of cases. At the same time, participants in BC and CC screenings experienced discomfort in 38.1 % and 42.5 % of cases, respectively (p = 0.001). Analysis of internal consistency on the questionnaire on awareness of the screening procedure showed the value of Cronbach's Alpha 0.693. The scores of subjective feelings during screening were 0.702. CONCLUSIONS The study's results revealed the reliability and applicability of the questionnaires on awareness of the screening procedure and assessment of subjective feelings. Knowledge of general information about the screening program differed depending on the type of screening. Participants in BC and CC screening were more likely to be aware of the screening program than participants in PC screening. An unpleasant circumstance associated with screening test is most often considered the very fact of having the test, especially for participants in BC and CC screening. The results of this study highlight the importance of providing an information campaign to raise awareness about screening tests. In addition, the results indicate the need to provide patients with full information about the screening process, and possible risks and benefits.
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Affiliation(s)
- Alfiya Shamsutdinova
- JSC «Central Clinical Hospital», Almaty, Republic of Kazakhstan.
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan.
| | - Botagoz Turdaliyeva
- Kazakhstan Medical University “Kazakhstan School of Public Health”, Almaty, Republic of Kazakhstan.
| | - Shynar Tanabayeva
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan.
| | - Aida Omarova
- Astana Medical University, Astana, Republic of Kazakhstan.
| | - Timur Saliev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan.
| | | | - Ildar Fakhradiyev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan.
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Naber SK, Almadi MA, Guyatt G, Xie F, Lansdorp-Vogelaar I. Cost-effectiveness analysis of colorectal cancer screening in a low incidence country: The case of Saudi Arabia. Saudi J Gastroenterol 2021; 27:208-216. [PMID: 33835054 PMCID: PMC8448011 DOI: 10.4103/sjg.sjg_526_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) screening is cost-effective in many Western countries, and many have successfully implemented CRC screening programs. For countries with a lower CRC incidence, like Saudi Arabia, the value of CRC screening is less evident and requires careful weighing of harms, benefits, and costs. METHODS We used the MISCAN-Colon microsimulation model to simulate a male and female cohort with life expectancy and CRC risk as observed in Saudi Arabia. For both cohorts, we evaluated strategies without screening, with annual or biennial faecal immunochemical testing (FIT), and with 10-yearly or once-only colonoscopy. We also considered different start and end ages of screening. For both cohorts, we estimated lifetime costs and effects of each strategy. We then identified a set of potentially cost-effective strategies using incremental cost-effectiveness ratios (ICERs) defined as the additional cost per additional quality-adjusted life year (QALY). RESULTS Without CRC screening, an estimated 14 per 1,000 males would develop CRC during their lifetime and 9 would die from CRC. Several strategies proved potentially cost-effective including biennial FIT at ages 55-65 (ICER of $7,400), once-only colonoscopy at age 55 (ICER of $7,700), and 10-yearly colonoscopy at ages 50-65, 45-65, and 45-75 (ICERs of $34,000, 71,000, and 375,000, respectively). For females, risk of CRC was lower and CRC screening was therefore less cost-effective, but efficient strategies were largely similar. CONCLUSIONS Despite low CRC incidence in Saudi Arabia, some FIT or colonoscopy screening strategies may meet reasonable thresholds of cost-effectiveness. The optimal strategy will depend on multiple factors including the willingness to pay per QALY, the colonoscopy capacity, and the accepted budget impact.
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Affiliation(s)
- Steffie K. Naber
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Majid A. Almadi
- Department of Medicine, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Department of Medicine, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence and Impact, Centre for Health Economics and Policy Analysis (CHEPA), Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, Centre for Health Economics and Policy Analysis (CHEPA), Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada,Centre for Health Economics and Policy Analysis (CHEPA), Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Iris Lansdorp-Vogelaar
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Address for correspondence: Dr. Iris Lansdorp-Vogelaar, Erasmus MC, University Medical Center, Department of Public Health, P.O. 2040, 3000 CA, Rotterdam, The Netherlands. E-mail:
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Kabiri N, Khodayari-zarnaq R, Khoshbaten M, Arab-Zozani M, Janati A. Gastrointestinal cancer prevention policies in Iran: A policy analysis of agenda-setting using Kingdon’s multiple streams. J Cancer Policy 2021; 27:100265. [DOI: 10.1016/j.jcpo.2020.100265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023]
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Janati A, Khodayari-Zarnaq R, Khanijahani A, Khoshbaten M, Ghamkhar A, Kabiri N. Adherence to the new policy framework of the World Cancer Research Fund International in developing a policy package for the prevention of gastrointestinal cancers in Iran: a Delphi study. Glob Health Action 2021; 14:1978661. [PMID: 34586047 PMCID: PMC8491721 DOI: 10.1080/16549716.2021.1978661] [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] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Gastrointestinal cancers in Iran are among the major non-communicable diseases with a considerable burden on the health system. Changes in lifestyles as well as environmental factors have resulted in the emergence of these cancers. OBJECTIVE To elicit and quantitatively verify experts' opinions regarding the potential public health impact, feasibility, economic impact, and budgetary impact of gastrointestinal cancer prevention policies in Iran. METHODS Sixteen experts from Iran were recruited in an email-based, two-round Delphi study. In each round, a questionnaire of policy options for preventing gastrointestinal cancers, which adhered to the new policy framework of the World Cancer Research Fund International, was given to participants. In the first round, experts were asked to provide opinions for and against the policy options. The second round evaluated the policy options for their public health impact, feasibility, economic impact, and budgetary impact. RESULTS A total of 32 policy options were organized based on three domains: health-enhancing environments, system changes, and behavior change communications. Of the 32 policy options, there were consensus in 31 (96%) and 30 (93%) options for public health impact and feasibility, respectively. On study completion, experts reached a consensus in 29 of 32 (90%) policy options for economic impact; only on 26 (81%) of these policy options did participants reached consensus for budgetary impact. CONCLUSION Findings indicated that although nearly all policy options reached a consensus for their public health impact, some options are not feasible or do not appear to have an economic rationale for being implemented. Moreover, it is crucial to take into account the inter-sectoral collaboration between health and non-health sectors. Findings from this study can be helpful for health policymakers in identifying support for evidence-informed approaches regarding gastrointestinal cancer prevention.
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Affiliation(s)
- Ali Janati
- Iranian Center of Excellence in Health Management, Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahim Khodayari-Zarnaq
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Manouchehr Khoshbaten
- Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ghamkhar
- School of Nursing and Allied Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Neda Kabiri
- Research Center for Evidence based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Fritzell K, Forsberg A, Wangmar J, Wengström Y, Bottai M, Hultcrantz R. Gender, having a positive FIT and type of hospital are important factors for colonoscopy experience in colorectal cancer screening - findings from the SCREESCO study. Scand J Gastroenterol 2020; 55:1354-1362. [PMID: 32946700 DOI: 10.1080/00365521.2020.1820568] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Assessing the experience of screening procedures is crucial for improving the quality and acceptance of colonoscopy in colorectal cancer screening. The aim of the study was to investigate the colonoscopy experience and associated factors among individuals who underwent a colonoscopy in the Screening of Swedish Colons (SCREESCO) study. METHODS Participants in the Screening of Swedish Colons (SCREESCO; n = 7593) randomized clinical trial (colonoscopy vs. faecal immunochemical test (FIT)) were enrolled. The primary outcome was overall colonoscopy experience measured with a study-specific questionnaire. Secondary endpoints were measured using multiple regression analyses with factors that included sex, randomization group, geographical regions, university hospital, complications, sedation, clean bowel, time to cecum, and presence of polyps or cancer. RESULTS A total of 6572 (87%) individuals responded to the questionnaire. The majority was satisfied with the information, care and treatment. Women reported more worry, discomfort and pain, but also better information, care and treatment compared with men. The FIT group was more worried and perceived more discomfort and pain than the colonoscopy group. Type of hospital (geographical region; university hospital vs. not university hospital) was also a significant predictor for the colonoscopy experience. CONCLUSIONS Although most participants were satisfied with the colonoscopy experience, the study has highlighted areas for improvement. Important factors for colonoscopy experience were gender, randomization group, and type of hospital and therefore crucial to bear in mind when designing screening programs.
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Affiliation(s)
- Kaisa Fritzell
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Forsberg
- Department of Medicine Solna, Karolinska Institutet, Sweden
| | - Johanna Wangmar
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Matteo Bottai
- Division of Biostatics, Institution of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Cusumano VT, Corona E, Partida D, Yang L, Yu C, May FP. Patients without colonoscopic follow-up after abnormal fecal immunochemical tests are often unaware of the abnormal result and report several barriers to colonoscopy. BMC Gastroenterol 2020; 20:115. [PMID: 32306919 PMCID: PMC7168865 DOI: 10.1186/s12876-020-01262-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 04/03/2020] [Indexed: 02/08/2023] Open
Abstract
Background The fecal immunochemical test (FIT) is the second most commonly used colorectal cancer (CRC) screening modality in the United States; yet, follow-up of abnormal FIT results with diagnostic colonoscopy is underutilized. Our objective was to determine patient-reported barriers to diagnostic colonoscopy following abnormal FIT in an academic healthcare setting. Methods We included patients age 50–75 with an abnormal FIT result between 1/1/2015 and 10/31/2017 and no documented follow-up diagnostic colonoscopy. We abstracted demographic data from the electronic health record (EHR). Study personnel conducted telephone surveys with patients to confirm colonoscopy completion and elicit data on notification of FIT results and barriers to colonoscopy. We also provided brief verbal education about diagnostic colonoscopy. We calculated frequencies of demographic data and survey responses and compared survey responses by interest in colonoscopy after education. Results We surveyed 67 patients. Fifty-one were aware of the abnormal FIT result, and a majority learned of the abnormal FIT result by direct communication with providers (19, 37.3%) or EHR messaging (11, 21.6%). Overall, fifty-three patients (79.1%) confirmed lack of colonoscopy, citing provider-related (19, 35.8%), patient-related (16, 30.2%), system-related (1, 1.9%), or multifactorial (17, 32.1%) reasons. Lack of knowledge of FIT result (14, 26.4%) was most common. After brief education, 20 (37.7%) patients requested colonoscopy. Conclusion Patients with an abnormal FIT reported various multi-level barriers to diagnostic colonoscopy after abnormal FIT, including knowledge of FIT results. When provided with brief education, participants expressed interest in diagnostic colonoscopy. Future efforts will evaluate interventions to improve colonoscopy follow-up.
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Affiliation(s)
- Vivy T Cusumano
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Edgar Corona
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Diana Partida
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Liu Yang
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Christine Yu
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,Department of Gastroenterology, Southern California Permanente Medical Group, Los Angeles, California, USA
| | - Folasade P May
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. .,Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. .,UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, Los Angeles, California, USA. .,Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.
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Larsen MB, Njor SH, Jensen TM, Ingeholm P, Andersen B. Potential for prevention: a cohort study of colonoscopies and removal of adenomas in a FIT-based colorectal cancer screening programme. Scand J Gastroenterol 2019; 54:1008-1014. [PMID: 31397598 DOI: 10.1080/00365521.2019.1647282] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Introduction: Evidence suggests that colorectal cancer (CRC) screening using guaiac faecal occult blood tests (gFOBT) reduces the CRC burden by facilitating timely removal of adenomas. Yet, the faecal immunochemical test (FIT) is being implemented in many countries. The aim of this study was to analyse the risk of having adenomas detected when invited for FIT-based screening as compared to those not yet invited. Material and Methods: The study was designed as a register-based retrospective cohort study. The potential for prevention was estimated as number of individuals who had no adenomas, non-advanced adenomas, and advanced adenomas detected per 1000 invited/not yet invited individuals and the relative risk (RR) of each of the three outcomes. Results: A total of 1,359,340 individuals were included, 29.6% of whom had been invited and 70.4% had not yet been invited to participate in CRC screening. Compared with the not yet invited population, the invited group had a RR of no adenomas of 2.28 (2.22-2.34) and a RR of advanced adenomas of 7.41 (6.93-7.91). The RR of colonoscopy was 2.93 (2.87-2.99) for the invited population compared with the not yet invited population. Conclusion: The RR of having a colonoscopy was three times higher among those invited compared to those not yet invited for CRC screening and twice as often those who had been invited compared to those not yet invited had no adenomas detected. Still, the risk of advanced adenomas was more than seven times higher among the invited population, indicating that the screening programme holds great potential for reducing the CRC burden. Abbreviations: CI: Confidence interval; CRC: Colorectal cancer; FIT: Faecal immunochemical test; ICD: International Classification of Disease; RR: Relative risk.
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Affiliation(s)
- Mette Bach Larsen
- Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region , Randers , Denmark
| | - Sisse Helle Njor
- Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region , Randers , Denmark
| | | | - Peter Ingeholm
- Department of Pathology, Herlev Hospital, Capital Region of Denmark , Herlev , Denmark
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, Central Denmark Region , Randers , Denmark
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Kirkegaard P, Edwards A, Andersen B. A stitch in time saves nine: Perceptions about colorectal cancer screening after a non-cancer colonoscopy result. Qualitative study. PATIENT EDUCATION AND COUNSELING 2019; 102:1373-1379. [PMID: 30853142 DOI: 10.1016/j.pec.2019.02.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 02/23/2019] [Accepted: 02/25/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To explore perceptions of colorectal cancer (CRC) screening among participants who have experienced a 'false alarm' for CRC, and to explore perceptions about the relevance of screening for themselves or others. METHODS Semi-structured interviews with screening participants who had participated in the Danish CRC screening program and experienced a 'false alarm' for colorectal cancer. A thematic analysis was performed, based on an interpretive tradition of ethnography. RESULTS Perceptions about CRC screening after a non-cancer colonoscopy result were characterized by trust in the colonoscopy result showing no CRC, and satisfaction with the screening offer despite the risk for 'false alarm'. The patient-involving behavior of the healthcare professionals during the examination was for most participants a cornerstone for trusting the validity of the colonoscopy result showing no CRC. Strong notions about perceived obligation to participate in screening were common. CONCLUSIONS Prominent themes were trust in the result, satisfaction with the procedure, and moral obligations to participate both for themselves and for others. PRACTICE IMPLICATIONS Information to future invitees after a 'false alarm' experience could build on peoples' trust in the validity of a previous non-cancer result and should underscore the importance of subsequent screening even after a 'false alarm' for cancer.
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Affiliation(s)
- Pia Kirkegaard
- Department of Public Health Programmes, Randers, Denmark.
| | - Adrian Edwards
- Department of Public Health Programmes, Randers, Denmark; Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Berit Andersen
- Department of Public Health Programmes, Randers, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Timing Isn't Everything for Diagnostic Colonoscopy After Positive Results From a Fecal Immunohistochemical Test. Clin Gastroenterol Hepatol 2019; 17:1245-1247. [PMID: 30768964 DOI: 10.1016/j.cgh.2019.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 02/04/2019] [Indexed: 02/07/2023]
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