Browsing by Subject "colon cancer screening"

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    Early-Age Onset Colorectal Neoplasia in Average-Risk Individuals Undergoing Screening Colonoscopy: A Systematic Review and Meta-Analysis
    (Elsevier, 2021-10) Kolb, Jennifer M.; Hu, Junxiao; DeSanto, Kristen; Gao, Dexiang; Singh, Siddharth; Imperiale, Thomas; Lieberman, David A.; Boland, C. Richard; Patel, Swati G.; Medicine, School of Medicine
    Background/Aims Incidence and mortality associated with early age onset colorectal cancer (EAO-CRC) is increasing, prompting professional society recommendations to lower the screening age in average risk individuals. The yield of screening individuals <50 years old is not known. Methods A systematic review of 3 databases from inception through July 2020 was performed in all languages that reported colonoscopy findings in average risk individuals<50 years old. The primary outcomes were EAO colorectal neoplasia (EAO-CRN) and advanced colorectal neoplasia (EAO-aCRN) prevalence. Subgroup analyses were performed based on sex, geographic location, time period, and age including comparison to age 50-59. Generalized linear mixed model with random intercept logistic regression and fixed subgroup effects were performed Results Of 10,123 unique articles, 17 studies published between 2002-2020, including 51,811 average-risk individuals from four continents, were included. The pooled rate of EAO-CRN was 13.7% (95%CI: 0.112-0.168) and EAO-aCRN was 2.2% (95%CI: 0.016-0.031). Prevalence of CRC was .05% (0.00029-0.0008). Rates of EAO-CRN were higher in men compared to women (RR 1.71, 1.49–1.98), and highest in the United States (15.6%:12.2-19.7) compared to Europe (14.9%:6.9-29.3), East Asia (13.4%:10.3-17.2), and the Middle East (9.8%:7.8-12.2)(p=0.04) The rate of EAO-CRN in age 45-49 and 50-59 was 17.8% (14.5-21.6) and 24.8% (19.5-30.8), respectively (p=0.04). The rate of EAO-aCRN in age 45-49 was 3.6% (1.9-6.7) and 4.2% (3.2-5.7), respectively (p=0.69) Conclusions The rate of advanced colorecta neoplasia in individuals age 45-49 was similar to the rate observed in age 50-59, suggesting that expanding screening to this population could yield similar impact on colorectal cancer risk reduction.
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    A Randomized Trial to Compare a Tailored Web-Based Intervention and Tailored Phone Counseling to Usual Care for Increasing Colorectal Cancer Screening
    (AACR, 2018-12) Champion, Victoria L.; Christy, Shannon M.; Rakowski, William; Gathirua- Mwangi, Wambui G.; Tarver, Will L.; Carter-Harris, Lisa; Cohee, Andrea A.; Marley, Andrew R.; Jessup, Nenette M.; Biederman, Erika; Kettler, Carla D.; Stump, Timothy E.; Monahan, Patrick; Lairson, David R.; Rawl, Susan M.; School of Nursing
    Background: Colorectal cancer mortality could be decreased with risk-appropriate cancer screening. We examined the efficacy of three tailored interventions compared with usual care for increasing screening adherence. Methods: Women (n = 1,196) ages 51 to 74, from primary care networks and nonadherent to colorectal cancer guidelines, were randomized to (1) usual care, (2) tailored Web intervention, (3) tailored phone intervention, or (4) tailored Web + phone intervention. Average-risk women could select either stool test or colonoscopy, whereas women considered at higher than average risk received an intervention that supported colonoscopy. Outcome data were collected at 6 months by self-report, followed by medical record confirmation (attrition of 23%). Stage of change for colorectal cancer screening (precontemplation or contemplation) was assessed at baseline and 6 months. Results: The phone (41.7%, P < 0.0001) and combined Web + phone (35.8%, P < 0.001) interventions significantly increased colorectal cancer screening by stool test compared with usual care (11.1%), with ORs ranging from 5.4 to 6.8 in models adjusted for covariates. Colonoscopy completion did not differ between groups except that phone significantly increased colonoscopy completion compared with usual care for participants in the highest tertile of self-reported fear of cancer. Conclusions: A tailored phone with or without a Web component significantly increased colorectal cancer screening compared with usual care, primarily through stool testing, and phone significantly increased colonoscopy compared with usual care but only among those with the highest levels of baseline fear. Impact: This study supports tailored phone counseling with or without a Web program for increasing colorectal cancer screening in average-risk women.