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Decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer

Although colonoscopic surveillance is recommended both for individuals with known hereditary colorectal cancer (HCRC) syndromes and those with a more moderate familial colorectal cancer (FCRC) history, the evidence for the benefits of surveillance is limited and surveillance practices vary. This stu...

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Autores principales: Sjöström, Olle, Lindholm, Lars, Tavelin, Björn, Melin, Beatrice
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010828/
https://www.ncbi.nlm.nih.gov/pubmed/26935832
http://dx.doi.org/10.1007/s10689-016-9867-7
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author Sjöström, Olle
Lindholm, Lars
Tavelin, Björn
Melin, Beatrice
author_facet Sjöström, Olle
Lindholm, Lars
Tavelin, Björn
Melin, Beatrice
author_sort Sjöström, Olle
collection PubMed
description Although colonoscopic surveillance is recommended both for individuals with known hereditary colorectal cancer (HCRC) syndromes and those with a more moderate familial colorectal cancer (FCRC) history, the evidence for the benefits of surveillance is limited and surveillance practices vary. This study evaluates the preventive effect for individuals with a family history of CRC of decentralized colonoscopic surveillance with the guidance of a cancer prevention clinic. We performed a population based prospective study of 261 patients with HCRC or FCRC, recorded in the colonoscopic surveillance registry at the Cancer genetics clinic, University Hospital of Umeå, Sweden. Colonoscopic surveillance was conducted every second (HCRC) or fifth (FCRC) year at local hospitals in Northern Sweden. Main outcome measures were findings of high-risk adenomas (HRA) or CRC, and patient compliance to surveillance. Estimations of the expected numbers of CRC without surveillance were made. During a total of 1256 person years of follow-up, one case of CRC was found. The expected numbers of cancers in the absence of surveillance was between 9.5 and 10.5, resulting in a standardized incidence ratio, observed versus expected cases of CRC, between 0.10 (CI 95 % 0.0012–0.5299) and 0.11 (CI 95 % 0.0014–0.5857). No CRC mortality was reported, but three patients needed surgical intervention. HRA were found in 5.9 % (14/237) of the initial and in 3.4 % (12/356) of the follow-up colonoscopies. Patient compliance to the surveillance program was 90 % as 597 of the planned 662 colonoscopies were performed. The study concludes that colonoscopic surveillance with high patient compliance to the program is effective in preventing CRC when using a decentralized method for colonoscopy surveillance with the guidance of a cancer prevention clinic. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10689-016-9867-7) contains supplementary material, which is available to authorized users.
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spelling pubmed-50108282016-09-16 Decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer Sjöström, Olle Lindholm, Lars Tavelin, Björn Melin, Beatrice Fam Cancer Original Article Although colonoscopic surveillance is recommended both for individuals with known hereditary colorectal cancer (HCRC) syndromes and those with a more moderate familial colorectal cancer (FCRC) history, the evidence for the benefits of surveillance is limited and surveillance practices vary. This study evaluates the preventive effect for individuals with a family history of CRC of decentralized colonoscopic surveillance with the guidance of a cancer prevention clinic. We performed a population based prospective study of 261 patients with HCRC or FCRC, recorded in the colonoscopic surveillance registry at the Cancer genetics clinic, University Hospital of Umeå, Sweden. Colonoscopic surveillance was conducted every second (HCRC) or fifth (FCRC) year at local hospitals in Northern Sweden. Main outcome measures were findings of high-risk adenomas (HRA) or CRC, and patient compliance to surveillance. Estimations of the expected numbers of CRC without surveillance were made. During a total of 1256 person years of follow-up, one case of CRC was found. The expected numbers of cancers in the absence of surveillance was between 9.5 and 10.5, resulting in a standardized incidence ratio, observed versus expected cases of CRC, between 0.10 (CI 95 % 0.0012–0.5299) and 0.11 (CI 95 % 0.0014–0.5857). No CRC mortality was reported, but three patients needed surgical intervention. HRA were found in 5.9 % (14/237) of the initial and in 3.4 % (12/356) of the follow-up colonoscopies. Patient compliance to the surveillance program was 90 % as 597 of the planned 662 colonoscopies were performed. The study concludes that colonoscopic surveillance with high patient compliance to the program is effective in preventing CRC when using a decentralized method for colonoscopy surveillance with the guidance of a cancer prevention clinic. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10689-016-9867-7) contains supplementary material, which is available to authorized users. Springer Netherlands 2016-03-02 2016 /pmc/articles/PMC5010828/ /pubmed/26935832 http://dx.doi.org/10.1007/s10689-016-9867-7 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Sjöström, Olle
Lindholm, Lars
Tavelin, Björn
Melin, Beatrice
Decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer
title Decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer
title_full Decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer
title_fullStr Decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer
title_full_unstemmed Decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer
title_short Decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer
title_sort decentralized colonoscopic surveillance with high patient compliance prevents hereditary and familial colorectal cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010828/
https://www.ncbi.nlm.nih.gov/pubmed/26935832
http://dx.doi.org/10.1007/s10689-016-9867-7
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