National Cancer Institute®
Last Modified: June 1, 2002
UI - 11950803
AU - Bretthauer M; Thiis-Evensen E; Huppertz-Hauss G; Gisselsson L; Grotmol
TI - T; Skovlund E; Hoff G NORCCAP (Norwegian colorectal cancer prevention): a randomised trial to assess the safety and efficacy of carbon dioxide versus air insufflation in colonoscopy.
SO - Gut 2002 May;50(5):604-7
AD - NORCCAP-Centre, Telemark Central Hospital, Porsgrunn, Norway Department of Anaesthesiology, Telemark Central Hospital, Porsgrunn, Norway. firstname.lastname@example.org
BACKGROUND: To eliminate the risk of combustion during electrosurgical procedures and to reduce patient discomfort, carbon dioxide (CO2) insufflation has been recommended during colonoscopy. However, air insufflation is still the standard method, perhaps due to the lack of suitable equipment and shortage of randomised studies. AIMS: This randomised controlled trial was conducted to assess patient tolerance and safety when using CO2 insufflation during colonoscopy. PATIENTS: Over an eight month period a successive series of patients referred for a baseline colonoscopy due to findings in a flexible sigmoidoscopy screening trial were randomly assigned to the use of either air or CO2 insufflation during colonoscopy. METHODS: End tidal CO2 (ETCO2), a non-invasive parameter of arterial pCO2, was registered before and repeatedly during and after the examination. The patient's experience of pain during and after the examination was registered using a visual analogue scale (VAS). Sedation was not used routinely. RESULTS: CO2 insufflation was used in 121 patients (51%) and air in 119 patients (49%). The groups were similar in age, sex, and caecal intubation rate. No rise in ETCO2 was registered. There were statistically significant differences in VAS scores between the groups with less pain reported when using CO2. CONCLUSIONS: This randomised study of unsedated patients shows that CO2 insufflation is safe during colonoscopy with no rise in ETCO2 level. CO2 was found to be superior to air in terms of pain experienced after the examination.
UI - 11501466
AU - Canadian Task Force on Preventive Health Care
TI - Colorectal cancer screening. Recommendation statement from the Canadian Task Force on Preventive Health Care.
SO - CMAJ 2001 Jul 24;165(2):206-8
UI - 11772963
AU - Jorgensen OD; Kronborg O; Fenger C
TI - A randomised study of screening for colorectal cancer using faecal occult blood testing: results after 13 years and seven biennial screening rounds.
SO - Gut 2002 Jan;50(1):29-32
AD - Department of Surgical Gastroenterology, Odense University Hospital, Denmark.
BACKGROUND: Three randomised trials have demonstrated reduction in mortality from colorectal cancer (CRC) by repeated screening with faecal occult blood tests, including the trial presented here, which is the only one still in progress. AIMS: To evaluate reduction in mortality after seven screening rounds and the possible influence of compliance on mortality from CRC. METHODS: At Funen in Denmark, random allocation to biennial screening with Hemoccult-II in 30 967 subjects aged 45-75 years and 30,966 controls was performed in 1985 from a population of 137,485 of the same age. Only participants who completed the first screening round were invited for further screening. Colonoscopy was offered if the test was positive. The primary end point was death from CRC, and the 10 year results were published in 1996. RESULTS: From the beginning of the first screening to the seventh round, mean age increased from 59.8 to 70.0 years in the screening and control groups, and the male/female ratio decreased from 0.92 to 0.81. Those who accepted screening were younger than non-responders. Positivity rates varied from 0.8% to 3.8%, the cumulative ratio of a positive test was 5.1% after seven rounds, and 4.8% of patients had at least one colonoscopy. Mortality from CRC was significantly less in the screening group (relative risk (RR) 0.82 (0.69-0.97)), and the reduction in mortality was most pronounced above the sigmoid colon. After seven rounds, RR was reduced to less than 0.70 compared with controls. Mortality rates from causes other than CRC did not differ. Non-responders had a significantly increased risk of death from CRC compared with those who accepted the full programme. Subjects who accepted the first screening, but not subsequent ones, demonstrated a tendency towards increased risk. CONCLUSIONS: The persistent reduction in mortality from CRC in a biennial screening program with Hemoccult-II, and a reduction in RR to less than 0.70 in those adhering to the programme, support attempts to introduce larger scale population screening programmes. The smaller effect on mortality from CRC in the rectum and sigmoid colon suggests evaluation by additional flexible sigmoidoscopy with longer intervals.
UI - 11793634
AU - North GL
TI - Celecoxib as adjunctive therapy for treatment of colorectal cancer.
SO - Ann Pharmacother 2001 Dec;35(12):1638-43
AD - School of Pharmacy, University of Montana, Missoula, MT, USA. email@example.com
OBJECTIVE: To describe the role of celecoxib as adjunctive therapy in the treatment of familial adenomatous polyposis (FAP), an inherited autosomal dominant predisposition syndrome for colorectal cancer. DATA SOURCES: Literature was evaluated through MEDLINE search (1995-March 2000) and through secondary sources, using the search terms celecoxib, cyclooxygenase-2 inhibitors, and familial adenomatous polyps. DATA SYNTHESIS: Observational studies have found a decreased rate of colorectal cancer in people who regularly took aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs). The Food and Drug NSAID celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, for adjunctive therapy in patients with FAP, based on a six-month, randomized, controlled clinical trial. CONCLUSIONS: Aspirin and other NSAIDs reduce the incidence of colorectal cancer in the general population. Limited clinical studies in patients with FAP using nonaspirin NSAIDs have shown a reduction in polyp burden. A current clinical trial using celecoxib has also shown a reduction in polyp burden in patients with FAP. The long-term clinical impact of using a selective COX-2 inhibitor is not known, since celecoxib has not been studied beyond six months in patients with FAP. By reducing the polyp burden in FAP patients, celecoxib may be useful as adjunctive chemotherapy, in addition to routine endoscopic surveillance and surgery.
UI - 11889672
AU - Desjardins LA
TI - Hepatocellular carcinoma.
SO - Clin J Oncol Nurs 2002 Mar-Apr;6(2):107-8
AD - LDesjardins@NYC.RR.com
Hepatocellular carcinoma (HCC) is a common malignancy worldwide and is a disease of multifactorial etiology. Strong correlations exist between the prevalence of the hepatitis B and C viruses and HCC incidence. HCC treatment may involve surgical resection, liver transplantation, locoregional treatments, and chemotherapy. Prevention of virus-related HCC is contingent upon control of hepatitis types B and C. Universal vaccination against hepatitis B could eliminate hepatitis B-related HCC; however, hepatitis C-related HCC still could occur because a vaccine for hepatitis C currently is not available. Individuals at risk for HCC should be screened for the disease. Early detection could result in improved prognosis and survival.
UI - 11989264
AU - Moriwaki H
TI - [Prevention of liver neoplasms]
SO - Nippon Naika Gakkai Zasshi 2002 Mar 20;91 Suppl():63-6
UI - 11979443
AU - Kasum CM; Jacobs DR Jr; Nicodemus K; Folsom AR
TI - Dietary risk factors for upper aerodigestive tract cancers.
SO - Int J Cancer 2002 May 10;99(2):267-72
AD - Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.
We examined the association between whole-grain intake and incident upper aerodigestive tract cancer in a cohort of 34,651 postmenopausal, initially cancer-free women. We also studied established risk factors for upper aerodigestive cancers, including fruit and vegetable intake, smoking and alcohol intake. A mailed questionnaire at baseline in 1986 included a food-frequency questionnaire and assessment of other cancer risk factors. During the 14-year follow-up period, 169 women developed cancer of the upper aerodigestive tract. For all upper aerodigestive cancers together, significant inverse associations were observed for the highest compared to the lowest tertile of whole grains [relative risk (RR) = 0.53, 95% confidence interval (CI) 0.34-0.81] and yellow/orange vegetables (RR = 0.58, 95% CI 0.39-0.87). In addition, those in the highest compared to lowest tertile of fiber intake from whole grain were less likely to develop upper aerodigestive tract cancer (RR = 0.56, 95% CI 0.37-0.84); fiber intake from refined grain was not significantly associated with upper aerodigestive tract cancer. Findings were generally similar for oropharyngeal (n = 53), laryngeal (n = 21), nasopharyngeal/salivary (n = 18), esophageal (n = 21) and gastric (n = 56) cancers, though numbers of cases were too small for statistical testing within individual cancers. These findings confirm previous observations that high intake of fruits and vegetables and that intake of whole grains and the fiber derived from them may reduce risk of upper aerodigestive tract cancers. Copyright 2002 Wiley-Liss, Inc.
UI - 12066810
AU - Anonymous
TI - Second opinion. I recently had a colonoscopy where the doctors found a colon polyp that wasn't cancerous and removed it. What can I do to reduce my risk of developing more polyps?
SO - Mayo Clin Health Lett 2002 Jun;20(6):8
UI - 11383530
AU - Maric RN; Cheng KK
TI - Olive oil and colorectal cancer.
SO - J Epidemiol Community Health 2001 Jun;55(6):448
UI - 11813590
AU - Crespi M; Stigliano V; Assisi D
TI - Current trends in screening and secondary prevention of colorectal cancer.
SO - Hepatogastroenterology 2001 Nov-Dec;48(42):1635-40
AD - Service of Environmental Carcinogenesis, Epidemiology and Prevention, Gastroenterology Section, National Cancer Institute Regina Elena, Viale Regina Elena, 291, 00161 Rome, Italy. firstname.lastname@example.org
Colorectal cancer is one of the most frequent neoplasms in Western countries with an estimated 400,000 deaths per year worldwide. Several randomized studies have demonstrated that screening programs with FOBT (Fecal Occult Blood Test) reduce mortality from 18 to 33%, whereas case-control and cohort studies with endoscopy have shown a mortality reduction ranging from 60 to 76%. The target population for secondary prevention is men and women aged more than 50 years and younger subjects in case first-degree relatives are affected or the family pedigree raises the suspicion of a genetic syndrome. This report summarizes the results of different screening strategies for average risk patients (FOBT, anamnestic risk questionnaire, sigmoidoscopy, colonoscopy and virtual colonoscopy) and the surveillance protocols applicable to high-risk patients, particularly for hereditary syndromes such as HNPCC and FAP.
UI - 10796903
AU - Gazelle GS; McMahon PM; Scholz FJ
TI - Screening for colorectal cancer.
SO - Radiology 2000 May;215(2):327-35
AD - Department of Radiology, Decision Analysis and Technology Assessment Group, Zero Emerson Pl, Suite 2H, Boston, MA 02114, USA. gazelle@email@example.com
Colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer deaths in the United States. Fortunately, both the incidence and mortality associated with the disease have declined during the past 2 decades. This is likely due, at least in part, to improved efforts at screening and more aggressive removal of adenomatous polyps. However, colorectal cancer screening is still generally underutilized. This article reviews the current status and future outlook for colorectal cancer screening, including a discussion of risk factors for the disease, its anatomic distribution, proposed mechanisms of development from adenomatous polyps, rationale for screening, and screening options. Published literature concerning the cost-effectiveness of colorectal cancer screening is also summarized. The article concludes with a discussion of the emerging consensus regarding the importance of and approaches to screening.
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