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High-risk patients with colorectal cancer lack knowledge about colonoscopy

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Colorectal cancer

Cancer — histopathological features of colon carcinoids. Credit: Wikipedia / CC BY-SA 3.0

Colorectal cancer is the third most common cause of cancer death in the United States, and advanced colorectal polyps are a major risk factor. These high-risk patients are three times more likely to develop colorectal cancer, so a 3-year follow-up interval for colonoscopy is generally recommended. Many clinicians rely on self-reports from their high-risk patients to explain the need for repeated colonoscopies and the appropriate intervals.

In a study published in Journal of Gastroenterology and GastroenterologyResearchers at Florida Atlantic University’s Schmidt Medical College analyzed data from 2013 to 2017 for four years and investigated this knowledge. .. They analyzed data from structured interviews with 84 subjects aged 40 to 91 years, with proven biopsy progress. ..

The results showed that 28.6% were unaware of the need for repeats. Or an appropriate monitoring interval. Of these, 16.6% did not know the appropriate 3-year interval to undergo follow-up surveillance colonoscopy. In addition, 12% were unaware that follow-up surveillance colonoscopy was needed.

Screening method Includes fecal immunotesting, multi-targeted stool DNA testing, flexible sigmoidoscopy, and colonoscopy.

“Our data show a lack of biopsy-proven knowledge of patients with advanced colorectal polyps about the need for repeated colonoscopies and appropriate monitoring intervals,” Schmidt Medical College. “For patients with advanced colorectal polyps proven by biopsy, the interval between colonoscopy is about 3 years. Our data poses the challenge of relying on something more objective. Than self-report. Clinicians need to have the ability and willingness to share objective findings with all clinical colleagues involved in patient care. These efforts should also include young patients such as Chadwick Boseman, who recently died of colon cancer at the age of 43. “

The incidence of colorectal cancer is increased in young people. According to the American Cancer Society, between 2007 and 2016, the incidence of colorectal cancer over the age of 55 decreased by 3.6% each year, while those under the age of 55 increased by 2% each year.

“Data from our study poses clinical and public health challenges to reduce the recurrence rate of colorectal polyps and the risk of subsequent colorectal cancer in these high-risk patients,” Charles H. Dr. Hennekens, Ph.D., Senior Author, First Sir Richard Doll, and Senior Academic Advisor to FAU’s Schmidt Medical College. “More than 90% of patients diagnosed with colorectal cancer are over 50 years of age. The main risk factors for colorectal cancer are similar to those of heart attack and stroke, including overweight, obesity, type 2 diabetes, and lack of exercise. There is. “

Researchers say that if such a strategy is adopted for all patients, it will have significant clinical and public health implications. Specifically, it avoids overuse of colonoscopy for low-risk patients and increases both the benefit-to-risk ratio and the benefit-to-cost ratio from a public health perspective.

Additional risk factors, according to the US Centers for Disease Control and Prevention Crohn’s disease and ulcerative colitis. Personal or family history of colorectal cancer or colorectal polyps; genetic syndromes such as familial adenomatous polyposis and hereditary nonpolyposis colon (Lynch syndrome).


Risk of polyps and colorectal cancer


For more information:
Evin Rothschild and others. Lack of knowledge about colonoscopy in high-risk patients: clinical and public health challenges. Gastrointestinal and digestive journals. www.opastonline.com/storage/20… allenges-jgds-20.pdf

Quote: Patients at high risk for colorectal cancer lack knowledge about colonoscopy (September 14, 2020). https: //medicalxpress.com/news/2020-09-high-risk-patients-colorectal-cancer-lack.html

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