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1.
Objectives The association between screening sensitivity, transition probability, and individual’s age in FOBT for colorectal cancer
are explored, for both males and females.
Methods We apply the statistical method developed by Wu et al. [1] using the Minnesota colorectal cancer study group data, to make Bayesian inference for the age-dependent screening test
sensitivity, the age-dependent transition probability from disease-free to preclinical state, and the sojourn time distribution,
for both male and female participants in a periodic screening program. This gives us more information on the effectiveness
of the fecal occult blood test in colorectal cancer detection.
Results The sensitivity appears to increase with age for both genders. However, the posterior mean sensitivity is not monotonic with
age for males; it has a peak around age 74. The standard errors of the sensitivity are not monotone either; there is a minimum
at age 69 for males and at age 78 for females. The age-dependent transition probability is not a monotone function of age;
it has a single maximum at age 72 for males and a single maximum at age 75 for females. The age dependency seems more dramatic
for females than for males. The posterior mean sojourn time is 4.08 years for males and 2.41 years for females, with a posterior
median of 1.66 years for males and 1.88 years for females. The 95% highest posterior density (HPD) interval is (0.97, 20.28)
for males and (1.15, 5.96) for females, which are very large ranges, especially for males. The reason might be that there
were fewer men than women in the annual screening program.
Conclusion Reliable estimates of age-dependent sensitivity and transition probability are of great value to policy-makers regarding the
initial age for colorectal cancer screening exams. We found that the mean sojourn time for males is much longer than that
for females, which may imply that FOBT screening for colorectal cancer may be more effective for males than for females. 相似文献
2.
Cotterchio M Manno M Klar N McLaughlin J Gallinger S 《Cancer causes & control : CCC》2005,16(7):865-875
Objective: This is the first study to evaluate the association between colonic screening and colorectal cancer risk among Canadians.Methods: A case–control study was conducted. Cases were diagnosed with cancer of the colorectum, between 1997 and 2000, aged 20 to 74 years, identified through the population-based Ontario Cancer Registry and recruited by the Ontario Familial Colorectal Cancer Registry. Controls were a sex- and age-matched random sample of the population of Ontario. 971 cases and 1944 controls completed questionnaires (including colorectal screening history and many risk factors). Multivariate logistic regression analysis was used to obtain adjusted odds ratios (OR) estimates.Results: Having had a fecal occult blood screen was associated with reduced colorectal cancer risk (OR=0.76; 95% confidence interval (CI): 0.59, 0.97). Having had a screening sigmoidoscopy was associated with a halving of colorectal cancer risk (OR = 0.52; 95% CI: 0.34, 0.80). Having had a screening colonoscopy did not significantly reduce colorectal cancer risk (OR = 0.69; 95% CI: 0.44, 1.07); however, having had either screening endoscopy was associated with a significant reduction in colorectal cancer risk (OR = 0.62; 95% CI: 0.44, 0.87). Findings differed slightly by anatomic sub-site (proximal and distal colorectum).Conclusions: We report a reduction in colorectal cancer risk among persons who underwent colorectal cancer screening; in particular, sigmoidoscopy. Findings are of great importance for the prevention of colorectal cancer.*Financial Support – This work was supported by the National Cancer Institute, National Institutes of Health under RFA # CA-95-011 (grant no. U01-CA74783). 相似文献
3.
Deborah K. Mayer Norma C. Terrin Usha Menon Gary L. Kreps Kathy McCance Susan K. Parsons Kathleen H. Mooney 《Journal of cancer survivorship》2007,1(1):17-26
Introduction Ten percent of all new cancers are diagnosed in cancer survivors and second cancers are the sixth leading cause of cancer
deaths. Little is known, however, about survivors’ screening practices for other cancers. The purpose of this study was to
examine the impact of a cancer diagnosis on survivors’ screening beliefs and practices compared to those without a cancer
history.
Materials and methods This study examined cancer survivors’ (n = 619) screening beliefs and practices compared to those without cancer (n = 2,141) using the National Cancer Institute’s 2003 Health Information National Trends Survey (HINTS).
Results The typical participant was Caucasian, employed, married, and female with at least a high school education, having a regular
health care provider and health insurance. Being a cancer survivor was significantly associated with screening for colorectal
cancer but not for breast or prostate cancer screening. Screening adherence exceeded American Cancer Society recommendations,
national prevalence data, and Healthy People 2010 goals for individual tests for both groups. Physician recommendations were
associated with a higher level of screening but recommendations varied (highest for breast cancer and lowest for colorectal
cancer screening).
Conclusions Cancer survivors had different health beliefs and risk perceptions for screening compared to the NoCancer group. While there
were no differences between survivors’ screening for breast and prostate cancer, survivors were more likely to screen for
colorectal cancer than the comparison group. Screening adherence met or exceeded recommendations for individual tests for
both cancer survivors and the comparison group.
Implications for cancer survivors Cancer survivors should continue to work with their health care providers to receive age and gender appropriate screening
for many types of cancers. Screening for other cancers should also be included in cancer survivorship care plans.
相似文献
Deborah K. MayerEmail: |
4.
Sue Wilson Michael JO Wakelam Richard FD Hobbs Angela V Ryan Janet A Dunn Val D Redman Fiona Patrick Lynne Colbourne Ashley Martin Tariq Ismail 《BMC cancer》2006,6(1):258
Background
Bowel cancer is common and is a major cause of death. Meta-analysis of randomised controlled trials estimates that screening for colorectal cancer using faecal occult blood (FOB) test reduces mortality from colorectal cancer by 16%. However, FOB testing has a low positive predictive value, with associated unnecessary cost, risk and anxiety from subsequent investigation, and is unacceptable to a proportion of the target population. Increased levels of an enzyme called matrix metalloproteinase 9 (MMP-9) have been found to be associated with colorectal cancer, and this can be measured from a blood sample. Serum MMP-9 is potentially an accurate, low risk and cost-effective population screening tool. This study aims to evaluate the accuracy of serum MMP-9 as a test for colorectal cancer in a primary care population. 相似文献5.
Sébastien Couraud Nicolas Girard Sylvie Erpeldinger François Gueyffier Gilles Devouassoux Guy Llorca Pierre Jean Souquet 《Clinical lung cancer》2013,14(5):574-580
BackgroundScreening for lung cancer by low-dose computed tomography scan (LDCTS) has been demonstrated to reduce lung cancer–specific and overall mortality rates in high-risk individuals. From trial to clinical practice, it is crucial to obtain an accurate level of knowledge of the physicians who will recruit patients for a screening program. The actual current practice and knowledge of practitioners are unknown. This could be critical to develop dedicated continuous medical education programs.Materials and MethodsThree groups of French physicians—pulmonologists (PUs), thoracic oncologists (TOs), and general practitioners (GPs)—were surveyed through a dedicated questionnaire on lung cancer screening.ResultsA total of 242 physicians answered the questionnaire; 81% of TOs knew that LDCTS showed efficacy for screening lung cancer compared with 52% of PUs and 18% of GPs (P < .0001). Approximately one third of physicians recommended lung cancer screening in daily practice at the time of the survey, including 53% of PUs, 34% of TOs, and 20% of GPs (P < .001). However, 94% of GPs, 44% of PUs, and 33% of TOs used inappropriate tests, mainly chest radiography. Most GPs proposed screening for all smokers, whereas PUs and TOs reserved screening for heavy smokers (P = .040). Most PUs and TOs recommended annual LDCTS (76%), whereas the majority of GPs sent patients for screening tests every 3 to 5 years (93%; P < .0001).ConclusionsThese results highlight the interest of physicians for lung cancer screening; meanwhile, our data stress the need for appropriate medical education and recommendations based on available evidence. 相似文献
6.
Beom Jin Kim Young-Ho Kim Dong Hyun Sinn Ki Joo Kang Jin Yong Kim Dong Kyung Chang Hee Jung Son Poong-Lyul Rhee Jae J. Kim Jong Chul Rhee 《Cancer causes & control : CCC》2010,21(6):939-944
Objective
We investigated the clinical usefulness of HbA1c in screening an average-risk group <50 years of age who need colonoscopy for colorectal cancer (CRC) screening. 相似文献7.
《Annals of oncology》2008,19(1):1
8.
Surveillance in Lynch Syndrome 总被引:1,自引:0,他引:1
The major aim of surveillance in Lynch syndrome is to diagnose malignant or premalignant lesions at the asymptomatic stage by regular checkups, particularly in the large bowel. Therefore, screening for colorectal adenomas and carcinomas by regular colonoscopies is the main topic of the present review. However, it should be remembered, that primary prevention – whether through the use of chemoprevention or the promotion of a healthy life-style may form a significant part of such surveillance in the future. Observational studies indicate that the adenoma carcinoma sequence is the main pathway in the development of colorectal cancer in Lynch syndrome. A colonoscopy every 1–3 years starting at age 20 to 25 years and the removal of observed adenomas is recommended for individuals known to have Lynch syndrome associated mutations. The incidence of colorectal cancer in family branches screened this way is lower than that in past unscreened generations. The screening of other malignancies associated with Lynch syndrome is more complex. Screening for endometrial cancer has recommended previously, but no benefits have been shown in recent studies. The value of screening for other extracolonic cancers remains also uncertain. 相似文献
9.
Maria Ramos Magdalena Esteva Jesús Almeda Elena Cabeza Diana Puente Rosa Saladich Albert Boada Maria Llagostera 《BMC cancer》2010,10(1):500
Background
Primary health care (PHC) professionals play a key role in population screening of colorectal cancer. The purposes of the study are: to assess knowledge and attitudes among PHC professionals with regard to colorectal cancer screening, as well as the factors that determine their support for such screening. 相似文献10.
Introduction Colorectal cancer survivors remain at risk for breast cancer. Thus, it is important to determine if screening mammography
rates are reduced by the diagnosis and treatment of incident colorectal cancer.
Methods Mammography rates among 7,666 67–79 year-old stage 0-III colorectal cancer survivors were compared with rates among 36,433
age-, race/ethnicity-, SEER area-matched women controlling for pre-diagnosis mammography, stage, chemotherapy, income, co-morbidities,
treatment in teaching hospital, number of physician visits, and gynecologist visits.
Results In the first 2 years after diagnosis, the survivors’ rate (49.7/100) was 4.2% higher than the controls’ (47.6/100), p < 0.001. It was 7.5% higher in the next 2 years, 54.5/100 versus 49.7/100, p < 0.001. The higher rates resulted from significantly greater rates among survivors without prior mammography, 30.9/100,
compared with their controls (25.3/100) in the first 2 years, for example (O.R. = 1.23, 95% C.I. = 1.15–1.32). The strongest
predictors of post-diagnosis mammography were pre-diagnosis mammography (O.R. = 5.76, 95% C.I. = 5.19–6.38), visiting a gynecologist
(O.R. = 1.83, 95% C.I. = 1.55–2.16), chemotherapy (O.R. = 1.61, 95% C.I. = 1.40–1.86), and more than nine physician visits.
Increasing Charlson scores and cancer stage were associated with lower mammography rates.
Discussion/Conclusions Overall, the competing demands of cancer diagnosis and treatment did not reduce mammography rates, and these events were associated
with increased rates among previous non-users.
Implications for cancer survivors The low mammography rate among survivors with no history of a prior mammogram means that the physicians treating these women
must emphasize the need for such care. 相似文献
11.
Background
Due to the low participation in colorectal cancer screening, public preference for colorectal cancer screening modality was determined. 相似文献12.
Methodological considerations for disentangling a risk factor's influence on disease incidence versus postdiagnosis survival: The example of obesity and breast and colorectal cancer mortality in the Women's Health Initiative
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Elizabeth M. Cespedes Feliciano Ross L. Prentice Aaron K. Aragaki Marian L. Neuhouser Hailey R. Banack Candyce H. Kroenke Gloria Y.F. Ho Oleg Zaslavsky Howard D. Strickler Ting‐Yuan David Cheng Rowan T. Chlebowski Nazmus Saquib Rami Nassir Garnet Anderson Bette J. Caan 《International journal of cancer. Journal international du cancer》2017,141(11):2281-2290
Often, studies modeling an exposure's influence on time to disease‐specific death from study enrollment are incorrectly interpreted as if based on time to death from disease diagnosis. We studied 151,996 postmenopausal women without breast or colorectal cancer in the Women's Health Initiative with weight and height measured at enrollment (1993–1998). Using Cox regression models, we contrast hazard ratios (HR) from two time‐scales and corresponding study subpopulations: time to cancer death after enrollment among all women and time to cancer death after diagnosis among only cancer survivors. Median follow‐up from enrollment to diagnosis/censoring was 13 years for both breast (7,633 cases) and colorectal cancer (2,290 cases). Median follow‐up from diagnosis to death/censoring was 7 years for breast and 5 years for colorectal cancer. In analyses of time from enrollment to death, body mass index (BMI) ≥ 35 kg/m2 versus 18.5–<25 kg/m2 was associated with higher rates of cancer mortality: HR = 1.99; 95% CI: 1.54, 2.56 for breast cancer (p trend <0.001) and HR = 1.40; 95% CI: 1.04, 1.88 for colorectal cancer (p trend = 0.05). However, in analyses of time from diagnosis to cancer death, trends indicated no significant association (for BMI ≥ 35 kg/m2, HR = 1.25; 95% CI: 0.94, 1.67 for breast [p trend = 0.33] and HR = 1.18; 95% CI: 0.84, 1.86 for colorectal cancer [p trend = 0.39]). We conclude that a risk factor that increases disease incidence will increase disease‐specific mortality. Yet, its influence on postdiagnosis survival can vary, and requires consideration of additional design and analysis issues such as selection bias. Quantitative tools allow joint modeling to compare an exposure's influence on time from enrollment to disease incidence and time from diagnosis to death. 相似文献
13.
Newcomb PA Chia VM Hampton JM Doria-Rose VP Trentham Dietz A 《Cancer causes & control : CCC》2009,20(4):409-416
Epidemiologic studies of hormone therapy (HT) and colorectal cancer incidence consistently show an inverse association; however,
few studies have considered prediagnostic use of HT on mortality among colorectal cancer patients. We evaluated the relationship
of HT and survival among a population-based cohort of women with large bowel cancer. Cases (n = 1,297) were newly diagnosed with invasive cancer of the colon or rectum, aged 40–74 years at diagnosis, who were identified
by Wisconsin’s statewide registry (1988–1991; 1997–2001) for two case–control studies. Information on HT use and other colorectal
cancer risk factors was collected by standardized interview. There were 507 deaths (274 of these attributable to colorectal
cancer) over 8.4 years of follow-up through December 2005. Hormone use was not associated with colorectal cancer mortality
(adjusted hazard rate ratio = 1.09, confidence interval = 0.81–1.47). Colorectal cancer specific mortality was not associated
with HT when considered separately by preparation type. Stage did not modify this relationship. Long-term HT was weakly positively
associated with increased mortality after diagnosis of proximal colon, but not distal colon cancer. Because we detected no
differences in survival among users of HT compared to non-users, the results suggest that HT use may affect only the incidence
of some colorectal tumors. 相似文献
14.
Chiung-ju Liu Tara Fleck Joan Goldfarb Casey Green Elizabeth Porter 《Journal of cancer education》2011,26(4):701-707
Some of the biggest barriers to increase colorectal cancer screening are negative attitudes to screening tests. These negative
attitudes might be evoked through reading cancer prevention information and impede the decision to get screened. Forty-two
adults aged ≥50 years completed a 12-item attitude questionnaire after reading colorectal cancer prevention information. African-Americans
perceived that others had higher cancer risk than themselves whereas Caucasians did not show the difference. Regardless of
ethnicity and adherence to screening guidelines, no participants had strong feelings of fear and embarrassment. However, non-adherent
Caucasians had higher anxiety than adherent Caucasians. The degree of negativity was not associated with intention to get
screened in non-adherent participants. Adequate health literacy of participants may account for flat responses in negative
attitudes. Further research in individuals with limited health literacy is recommended. Moreover, additional education about
self-relevance of cancer risk is considered necessary to increase cancer awareness in African-Americans. 相似文献
15.
Tung T. Nguyen Mary Beth Love Cindy Liang Lei-Chun Fung Thoa Nguyen Ching Wong Ginny Gildengorin Kent Woo 《Journal of cancer education》2010,25(3):405-412
The research team recruited eight Chinese American (seven females, one male) lay health workers (LHWs). They received 12 h
of training about colorectal cancer (CRC), its screening, and basic health education techniques. Each LHW were asked to recruit
ten participants and conduct two educational sessions. Of the 81 participants recruited, 73 had not received colorectal cancer
screening. Their mean age was 63.0 years, and 72.6% were women. Knowledge of colorectal cancer, its causes, and its screening
increased significantly. Receipt of first colorectal cancer screening test increased from 0.0% at baseline to 55.7% for fecal
occult blood tests, 7.1% for sigmoidoscopy, and 7.1% for colonoscopy. LHW outreach is feasible and may be effective in promoting
CRC screening among Chinese Americans. 相似文献
16.
Brent L. Johnson Amy Trentham-Dietz Kelli F. Koltyn Lisa H. Colbert 《Cancer causes & control : CCC》2009,20(5):775-784
Objective Increasing age and cancer history are related to impaired physical function. Since physical activity has been shown to ameliorate
age-related functional declines, we evaluated the association between physical activity and function in older, long-term colorectal
cancer survivors.
Methods In 2006–2007, mailed surveys were sent to colorectal cancer survivors, aged ≥65 years when diagnosed during 1995–2000, and
identified through a state cancer registry. Information on physical activity, physical function, and relevant covariates was
obtained and matched to registry data. Analysis of covariance and linear regression were used to compare means and trends
in physical function across levels of activity in the final analytic sample of 843 cases.
Results A direct, dose-dependent association between physical activity and function was observed (p
trend < .001), with higher SF-36 physical function subscores in those reporting high versus low activity levels (65.0 ± 1.7 vs.
42.7 ± 1.7 (mean ± standard error)). Walking, gardening, housework, and exercise activities were all independently related
to better physical function. Moderate–vigorous intensity activity (p
trend < .001) was associated with function, but light activity (p
trend = 0.39) was not.
Conclusion Results from this cross-sectional study indicate significant associations between physical activity and physical function
in older, long-term colorectal cancer survivors. 相似文献
17.
Objective
The aim of our study was to estimate the cost of colorectal cancer screening and to provide evidence for the cost control of colorectal cancer screening among general population in rural area of China. 相似文献18.
Background
Although colorectal cancer death rates have been declining, this trend is not consistent across all ethnic groups. Biological, environmental, behavioral and socioeconomic explanations exist, but the reason for this discrepancy remains inconclusive. We examined the hypothesis that improved cancer screening across all ethnic groups will reduce ethnic differences in colorectal cancer survival. 相似文献19.
Ardith Z. Doorenbos Clemma Jacobsen Rebecca Corpuz Ralph Forquera Dedra Buchwald 《Journal of cancer education》2011,26(3):549-554
This study seeks to ascertain whether a culturally tailored art calendar could improve participation in cancer screening activities.
We conducted a randomized, controlled calendar mail-out in which a Native art calendar was sent by first class mail to 5,633
patients seen at an urban American Indian clinic during the prior 2 years. Using random assignment, half of the patients were
mailed a “message” calendar with screening information and reminders on breast, colorectal, lung, and prostate cancer; the
other half received a calendar without messages. The receipt of cancer screening services was ascertained through chart abstraction
in the following 15 months. In total, 5,363 observations (health messages n = 2,695; no messages n = 2,668) were analyzed. The calendar with health messages did not result in increased receipt of any cancer-related prevention
outcome compared to the calendar without health messages. We solicited clinic input to create a culturally appropriate visual
intervention to increase cancer screening in a vulnerable, underserved urban population. Our results suggest that printed
materials with health messages are likely too weak an intervention to produce the desired behavioral outcomes in cancer screening. 相似文献