AIM: To investigate the association between adherence to health recommendations and detection of advanced colorectal neoplasia(ACN) in colorectal cancer(CRC) screening.METHODS: A total of 14832 women and men were invi...AIM: To investigate the association between adherence to health recommendations and detection of advanced colorectal neoplasia(ACN) in colorectal cancer(CRC) screening.METHODS: A total of 14832 women and men were invited to CRC screening, 6959 in the fecal immunochemical test arm and 7873 in the flexible sigmoidoscopy arm. These were also sent a self-reported lifestyle questionnaire to be completed prior to their first CRC screening. A lifestyle score was created to reflect current adherence to healthy behaviors in regard to smoking, body mass index, physical activity, alcohol consumption and food consumption, and ranged from zero(poorest) to six(best). Odds ratios(ORs) and 95%CIs were calculated using multivariable logistic regression to evaluate the association between the single lifestyle variables and the lifestyle score and the probability of detecting ACN.RESULTS: In all 6315 women and men completed the lifestyle questionnaire, 3323(53%) in the FIT arm and 2992(47%) in the FS arm. This was 89% of those who participated in screening. ACN was diagnosed in 311(5%) participants of which 25(8%) were diagnosed with CRC. For individuals with a lifestyle score of two, three, four, and five-six, the ORs(95%CI) for the probability of ACN detection were 0.82(0.45-1.16), 0.43(0.28-0.73), 0.41(0.23-0.64), and 0.41(0.22-0.73), respectively compared to individuals with a lifestyle score of zero-one. Of the single lifestyle factors, adherence to non-smoking and moderate alcohol intake were associated with a decreased probability of ACN detection compared to being a smoker or having a high alcohol intake 0.53(0.42-0.68) and 0.63(0.43-0.93) respectively.CONCLUSION: Adopted healthy behaviors were inversely associated with the probability of ACN detection. Lifestyle assessment might be useful for risk stratification in CRC screening.展开更多
AIM To investigate the possible long-term psychological harm of participating in colorectal cancer(CRC)screening in Norway.METHODS In a prospective, randomized trial, 14294 participants(aged 50-74 years) were invited ...AIM To investigate the possible long-term psychological harm of participating in colorectal cancer(CRC)screening in Norway.METHODS In a prospective, randomized trial, 14294 participants(aged 50-74 years) were invited to either flexible sigmoidoscopy(FS) screening, or a faecal immunochemical test(FIT)(1:1). In total, 4422 screening participants(32%) completed the questionnaire, which consisted of the Hospital Anxiety and Depression Scale and the SF-12, a generic health-related quality of life(HRQOL) measurement, when invited to screening and one year after the invitation. A control group of 7650 individuals was invited to complete the questionnaire only, at baseline and one year after, and 1911(25%) completed the questionnaires.RESULTS Receiving a positive or negative screening result and participating in the two different screening modalities did not cause clinically relevant mean changes in anxiety, depression or HRQOL after one year. FS screening, but not FIT, was associated with an increased probability of being an anxiety case(score ≥ 8) at the one-year follow-up(5.6% of FS participants transitioned from being not anxious to anxious, while 3.0% experienced the reverse). This increase was moderately significantly different from the changes in the control group(in which the corresponding numbers were 4.8% and 4.5%, respectively), P = 0.06. CONCLUSION Most individuals do not experience psychological effects of CRC screening participation after one year, while FS participation is associated with increased anxiety for a smaller group.展开更多
Less than 5%of colorectal adenomas will become malignant,but we do not have sufficient knowledge about their natural course to target removal of these5%only.Thus,95%of polypectomies are a waste of time exposing patien...Less than 5%of colorectal adenomas will become malignant,but we do not have sufficient knowledge about their natural course to target removal of these5%only.Thus,95%of polypectomies are a waste of time exposing patients to a small risk of complications.Recently,a new type of polyps,sessile serrated polyps,has attracted attention.Previously considered innocuous,they are now found to have molecular similarities to cancer and some guidelines recommend to have them removed.These lesions are often flat,covered by mucous,not easily seen and situated in the proximal colon where the bowel wall is thinner.Thus,polypectomy carries a higher risk of perforation than predominantly left-sided,stalked adenomas-and we do not know what is gained in terms of cancer prevention.Screening is a neat balance between harms and benefit for presumptively healthy participants not interested in risk exposure to obtain confirmation of being healthy.The situation is quite different for patient worried about symptom.Thus,the standards set for evidence-based practice may be higher for screening than for routine clinics-a mechanism which may benefit patients in the long run.展开更多
Background: Several studies indicate that endoscopy reports lack uniform content and terminology. Thus ASGE, ESGE, and WEO have prepared guidelines to improve the quality of endoscopy reports. However, the acceptance ...Background: Several studies indicate that endoscopy reports lack uniform content and terminology. Thus ASGE, ESGE, and WEO have prepared guidelines to improve the quality of endoscopy reports. However, the acceptance of such recommendations in the community of endoscopists has not been assessed. Objective: The aim of the present study was to determine Non-US endoscopists’ agreement to current ASGE guidelines for endoscopy reporting and ESGE recommendations for image documentation. Design: 137 endoscopists were invited to participate in this internet survey, covering 34 items regarding the content of the endoscopy reports. Non-responders received three e-mail reminders before the study was closed. Settings: A web-based survey tool developed at the University of Oslo was used to perform this study (https://wo.uio.no/as/WebObjects/nettskjema.woa). Results: Eighty (60%) of the 137 endoscopists responded, to the survey. Their agreement to the various items of the ASGE guidelines for text content ranged from 21% - 100%. Only 8.9% (95% CI, 4.4% - 17.2%) considered it necessary to perform routine image documentation according to the ESGE guidelines. Limitations: The response rate of 68%, is on the lower limit of acceptable. Conclusions: The cohort of endoscopists agrees partially to the ASGE guidelines. However, they do not consider systematic image documentation展开更多
文摘AIM: To investigate the association between adherence to health recommendations and detection of advanced colorectal neoplasia(ACN) in colorectal cancer(CRC) screening.METHODS: A total of 14832 women and men were invited to CRC screening, 6959 in the fecal immunochemical test arm and 7873 in the flexible sigmoidoscopy arm. These were also sent a self-reported lifestyle questionnaire to be completed prior to their first CRC screening. A lifestyle score was created to reflect current adherence to healthy behaviors in regard to smoking, body mass index, physical activity, alcohol consumption and food consumption, and ranged from zero(poorest) to six(best). Odds ratios(ORs) and 95%CIs were calculated using multivariable logistic regression to evaluate the association between the single lifestyle variables and the lifestyle score and the probability of detecting ACN.RESULTS: In all 6315 women and men completed the lifestyle questionnaire, 3323(53%) in the FIT arm and 2992(47%) in the FS arm. This was 89% of those who participated in screening. ACN was diagnosed in 311(5%) participants of which 25(8%) were diagnosed with CRC. For individuals with a lifestyle score of two, three, four, and five-six, the ORs(95%CI) for the probability of ACN detection were 0.82(0.45-1.16), 0.43(0.28-0.73), 0.41(0.23-0.64), and 0.41(0.22-0.73), respectively compared to individuals with a lifestyle score of zero-one. Of the single lifestyle factors, adherence to non-smoking and moderate alcohol intake were associated with a decreased probability of ACN detection compared to being a smoker or having a high alcohol intake 0.53(0.42-0.68) and 0.63(0.43-0.93) respectively.CONCLUSION: Adopted healthy behaviors were inversely associated with the probability of ACN detection. Lifestyle assessment might be useful for risk stratification in CRC screening.
基金Supported by the Ministry of Health and Care Services in Norway
文摘AIM To investigate the possible long-term psychological harm of participating in colorectal cancer(CRC)screening in Norway.METHODS In a prospective, randomized trial, 14294 participants(aged 50-74 years) were invited to either flexible sigmoidoscopy(FS) screening, or a faecal immunochemical test(FIT)(1:1). In total, 4422 screening participants(32%) completed the questionnaire, which consisted of the Hospital Anxiety and Depression Scale and the SF-12, a generic health-related quality of life(HRQOL) measurement, when invited to screening and one year after the invitation. A control group of 7650 individuals was invited to complete the questionnaire only, at baseline and one year after, and 1911(25%) completed the questionnaires.RESULTS Receiving a positive or negative screening result and participating in the two different screening modalities did not cause clinically relevant mean changes in anxiety, depression or HRQOL after one year. FS screening, but not FIT, was associated with an increased probability of being an anxiety case(score ≥ 8) at the one-year follow-up(5.6% of FS participants transitioned from being not anxious to anxious, while 3.0% experienced the reverse). This increase was moderately significantly different from the changes in the control group(in which the corresponding numbers were 4.8% and 4.5%, respectively), P = 0.06. CONCLUSION Most individuals do not experience psychological effects of CRC screening participation after one year, while FS participation is associated with increased anxiety for a smaller group.
文摘Less than 5%of colorectal adenomas will become malignant,but we do not have sufficient knowledge about their natural course to target removal of these5%only.Thus,95%of polypectomies are a waste of time exposing patients to a small risk of complications.Recently,a new type of polyps,sessile serrated polyps,has attracted attention.Previously considered innocuous,they are now found to have molecular similarities to cancer and some guidelines recommend to have them removed.These lesions are often flat,covered by mucous,not easily seen and situated in the proximal colon where the bowel wall is thinner.Thus,polypectomy carries a higher risk of perforation than predominantly left-sided,stalked adenomas-and we do not know what is gained in terms of cancer prevention.Screening is a neat balance between harms and benefit for presumptively healthy participants not interested in risk exposure to obtain confirmation of being healthy.The situation is quite different for patient worried about symptom.Thus,the standards set for evidence-based practice may be higher for screening than for routine clinics-a mechanism which may benefit patients in the long run.
文摘Background: Several studies indicate that endoscopy reports lack uniform content and terminology. Thus ASGE, ESGE, and WEO have prepared guidelines to improve the quality of endoscopy reports. However, the acceptance of such recommendations in the community of endoscopists has not been assessed. Objective: The aim of the present study was to determine Non-US endoscopists’ agreement to current ASGE guidelines for endoscopy reporting and ESGE recommendations for image documentation. Design: 137 endoscopists were invited to participate in this internet survey, covering 34 items regarding the content of the endoscopy reports. Non-responders received three e-mail reminders before the study was closed. Settings: A web-based survey tool developed at the University of Oslo was used to perform this study (https://wo.uio.no/as/WebObjects/nettskjema.woa). Results: Eighty (60%) of the 137 endoscopists responded, to the survey. Their agreement to the various items of the ASGE guidelines for text content ranged from 21% - 100%. Only 8.9% (95% CI, 4.4% - 17.2%) considered it necessary to perform routine image documentation according to the ESGE guidelines. Limitations: The response rate of 68%, is on the lower limit of acceptable. Conclusions: The cohort of endoscopists agrees partially to the ASGE guidelines. However, they do not consider systematic image documentation
