programas cribado cancer

Nota bibliográfica cribado c colorrectal 2014-11

Gill MD, Bramble MG, Hull MA, Mills SJ, Morris E, Bradburn DM, et al. Screen-detected colorectal cancers are associated with an improved outcome compared with stage-matched interval cancers. Br J Cancer. 2014;111(11):2076–81. Available from:

Conclusions: The improved survival of screen-detected over interval cancers for stages C and D suggest that there may be a biological difference in the cancers in each group. Although lead-time bias may have a role, this may be related to a tumour’s propensity to bleed and therefore may reflect detection through current screening tests.

Geraghty J, Butler P, Seaman H, Snowball J, Sarkar S, Blanks R, et al. Optimising faecal occult blood screening:retrospective analysis of NHS Bowel Cancer Screening data to improve the screening algorithm. Br J Cancer. 2014;111(11):2156–62. Available from:

Conclusions: This study demonstrated a strong correlation between SP% and cancer detection within the NHS BCSP. At the population level, subje…

Bagcchi S. CRC risk knowledge does not affect screening compliance. Lancet Oncol. 2014;15(13):e588. Available from: doi:

McQueen A, Swank PR, Vernon SW. Examining patterns of association with defensive information processing about colorectal cancer screening. J Health Psychol. England; 2014;19(11):1443–58. doi: 10.1177/1359105313493649. PMID: 23864072.
To reduce negative psychological affect from information or behavior that is inconsistent with one’s positive self-concept, individuals use a variety of defensive strategies. It is unknown whether correlates differ across defenses. We examined correlates of four levels of defensive information processing about colorectal cancer screening. Cross-sectional surveys were completed by a convenience sample of 287 adults aged 50-75 years. Defenses measures were more consistently associated with individual differences (especially avoidant coping styles); however, situational variables involving health-care providers also were important. Future research should examine changes in defenses after risk communication and their relative impact on colorectal cancer screening.

Chauvin P, Josselin J-M, Heresbach D. The influence of waiting times on cost-effectiveness: a case study of colorectal cancer mass screening. Eur J Heal Econ. Germany; 2014;15(8):801–12. doi: 10.1007/s10198-013-0525-9. PMID: 23974962.
When a cost-effectiveness analysis is implemented, the health-care system is usually assumed to adjust smoothly to the proposed new strategy. However, technological innovations in health care may often induce friction in the organization of care supply, implying the congestion of services and subsequent waiting times. Our objective here is to measure how these short run rigidities can challenge cost-effectiveness recommendations favorable to an innovative mass screening test for colorectal cancer. Using Markov modeling, we compare the standard Guaiac fecal occult blood test (gFOBT) with an innovative screening test for colorectal cancer, namely the immunological fecal occult blood test (iFOBT). Waiting time can occur between a positive screening test and the subsequent confirmation colonoscopy. Five scenarios are considered for iFOBT: no further waiting time compared with gFOBT, twice as much waiting time for a period of 5 or 10 years, and twice as much waiting time for a period of 5 or 10 years combined with a 25 % decrease in participation to confirmation colonoscopies. According to our modeling, compared with gFOBT, iFOBT would approximately double colonoscopy demand. Probabilistic sensitivity analysis enables concluding that the waiting time significantly increases the uncertainty surrounding recommendations favorable to iFOBT if it induces a decrease in the adherence rate for confirmation colonoscopy.

Poskus T, Strupas K, Mikalauskas S, Bitinaite D, Kavaliauskas A, Samalavicius NE, et al. Initial results of the National Colorectal Cancer Screening Program in Lithuania. Eur J Cancer Prev. 2014; doi: 10.1097/CEJ.0000000000000096. PMID: 25370682.
The aim of the present study was to review the National Colorectal Cancer Screening Program (the Program) in Lithuania according to the criteria set by the European Union. In Lithuania, screening services are provided free of charge to the population. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the Program has its own administrative code. All the information about the performance of the Program is collected in one institution - the NHIF. The results of the Program were retrieved from the database of NHIF from the start of the Program from 1 July 2009 to 1 July 2012. Descriptive analysis of epidemiological indicators was carried out. Results were compared with the references in the guidelines of the European Union for quality assurance in colorectal cancer (CRC) screening and diagnosis. Information service [which involves fecal immunochemical test (FIT)] was provided to 271 396 of 890 309 50-74-year-old residents. The screening uptake was 46.0% over 3 years. During this period, 19 455 (7.2%) FITs were positive and 251 941 (92.8%) FITs were negative. Referral for colonoscopy was performed in 10 190 (52.4%) patients. Colonoscopy was performed in 12 864 (66.1%) patients. Colonoscopy did not indicate any pathological findings in 8613 (67.0%) patients. Biopsies were performed in 4251 (33.0%) patients. The rate of high-grade neoplasia reported by pathologists was 3.9%; the rate of cancer was 3.1% of all colonoscopies. The rate of CRC detected by the Program was 0.2%. The CRC screening program in Lithuania meets most of the requirements for standardized CRC screening programs. The invitation coverage and rate of referral for colonoscopy after positive FIT should be improved.

Garcia M, Mila N, Binefa G, Benito L, Gonzalo N, Moreno V. Fecal hemoglobin concentration as a measure of risk to tailor colorectal cancer screening: are we there yet?. Eur J Cancer Prev. 2014; doi: 10.1097/CEJ.0000000000000090. PMID: 25370684.

 The aim of this paper was to examine the distribution of fecal hemoglobin (f-Hb) concentration in a Spanish colorectal cancer screening population according to sociodemographic characteristics and analyze whether f-Hb was associated with clinical outcomes (type of lesion and its location). From September 2009 to November 2012, we sent 77 744 invitations to individuals aged 50-69 years to provide one sample of feces. f-Hb was measured on samples from 27 606 screenees (35.5%). Colonoscopy findings and pathology data were collected on the 1406 screenees with f-Hb greater than 100 ng Hb/ml (20 mg Hb/g feces). The Mann-Whitney U-test and the Kruskal-Wallis test were used to compare f-Hb (median) according to sociodemographic variables, clinical outcomes, and histological features of adenomas. f-Hb from greater than 100 ng Hb/ml was categorized into quartiles. Regression models were used to determine whether f-Hb was a risk predictor of colorectal lesions. f-Hb was associated directly with the severity of the colorectal lesions. An overlap between individuals with a negative colonoscopy and those with a low-risk adenoma was observed. High-grade dysplasia, villous histology, distal location, and increasing size were all features associated with an increased f-Hb level. f-Hb could be used in individual risk assessment to determine surveillance strategies for colorectal cancer screening.

Clarke N, Sharp L, Osborne A, Kearney PM. Comparison of uptake of colorectal cancer screening based on faecal immunochemical testing (FIT) in males and females: A systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014; doi: 10.1158/1055-9965.EPI-14-0774. PMID: 25378366.

Conclusions:Meta analysis of FIT screening studies indicates significantly lower uptake among men. Impact:Further investigation is required into factors influencing acceptability and participation of FIT screening in both sexes.
Steffen A, Weber MF, Roder DM, Banks E. Colorectal cancer screening and subsequent incidence of colorectal cancer: results from the 45 and Up Study. Med J Aust. Australia; 2014;201(9):523–7. PMID: 25358576.

CONCLUSION: CRC incidence is lower among individuals with a history of CRC screening, through either FOBT or endoscopy, compared with individuals who have never had CRC screening, lasting for at least 4 years after screening.
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