Author
Christine M Mangham
Bio: Christine M Mangham is an academic researcher from Queen's University. The author has contributed to research in topics: Population & Mass screening. The author has an hindex of 1, co-authored 1 publications receiving 2709 citations.
Topics: Population, Mass screening
Papers
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TL;DR: Evidence from this study and other trials suggest that consideration should be given to a national programme of FOB screening to reduce CRC mortality in the general population.
2,778 citations
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University of Texas MD Anderson Cancer Center1, Oregon Health & Science University2, Mount Sinai St. Luke's and Mount Sinai Roosevelt3, American Cancer Society4, Veterans Health Administration5, Emory University6, Johns Hopkins University School of Medicine7, University of Pennsylvania8, Eastern Virginia Medical School9, Mayo Clinic10, Kaiser Permanente11, University of Wisconsin-Madison12, Indiana University – Purdue University Indianapolis13, Creighton University14, Memorial Sloan Kettering Cancer Center15
TL;DR: Clinicians should be prepared to offer patients a choice between a screening test that is effective at both early cancer detection and cancer prevention through the detection and removal of polyps and those that can detect cancer early and also can detect adenomatous polyps.
2,876 citations
TL;DR: Findings support the hypothesis that colonoscopic removal of adenomatous polyps prevents death from colorectal cancer.
Abstract: BACKGROUND In the National Polyp Study (NPS), colorectal cancer was prevented by colonoscopic removal of adenomatous polyps. We evaluated the long-term effect of colonoscopic polypectomy in a study on mortality from colorectal cancer. METHODS We included in this analysis all patients prospectively referred for initial colonoscopy (between 1980 and 1990) at NPS clinical centers who had polyps (adenomas and nonadenomas). The National Death Index was used to identify deaths and to determine the cause of death; follow-up time was as long as 23 years. Mortality from colorectal cancer among patients with adenomas removed was compared with the expected incidence-based mortality from colorectal cancer in the general population, as estimated from the Surveillance Epidemiology and End Results (SEER) Program, and with the observed mortality from colorectal cancer among patients with nonadenomatous polyps (internal control group). RESULTS Among 2602 patients who had adenomas removed during participation in the study, after a median of 15.8 years, 1246 patients had died from any cause and 12 had died from colorectal cancer. Given an estimated 25.4 expected deaths from colorectal cancer in the general population, the standardized incidence-based mortality ratio was 0.47 (95% confidence interval [CI], 0.26 to 0.80) with colonoscopic polypectomy, suggesting a 53% reduction in mortality. Mortality from colorectal cancer was similar among patients with adenomas and those with nonadenomatous polyps during the first 10 years after polypectomy (relative risk, 1.2; 95% CI, 0.1 to 10.6). CONCLUSIONS These findings support the hypothesis that colonoscopic removal of adenomatous polyps prevents death from colorectal cancer. (Funded by the National Cancer Institute and others.)
2,381 citations
Memorial Sloan Kettering Cancer Center1, Harvard University2, Indiana University3, University of Minnesota4, University of Utah5, Boston University6, University of California, San Diego7, Kaiser Permanente8, Virginia Commonwealth University9, Eastern Virginia Medical School10, University of Texas Southwestern Medical Center11, Mayo Clinic12
TL;DR: These guidelines differ from those published in 1997 in several ways: the screening interval for double contrast barium enema has been shortened to 5 years, and colonoscopy is the preferred test for the diagnostic investigation of patients with findings on screening and for screening patients with a family history of hereditary nonpolyposis colorectal cancer.
2,196 citations
TL;DR: This guideline report presents the panel’s recommendations with respect to screening and surveillance in people at average risk for CRC and those at increased risk because of a family history of CRC or genetic syndromes or a personal history of adenomatous polyps, inflammatory bowel disease, or curative-intent resection of CRC.
1,862 citations
TL;DR: Colonoscopic screening can detect advanced colonic neoplasms in asymptomatic adults with or without distal neoplasia, and many of these neoplasm would not be detected with sigmoidoscopy.
Abstract: Background and Methods The role of colonoscopy in screening for colorectal cancer is uncertain. At 13 Veterans Affairs medical centers, we performed colonoscopy to determine the prevalence and location of advanced colonic neoplasms and the risk of advanced proximal neoplasia in asymptomatic patients (age range, 50 to 75 years) with or without distal neoplasia. Advanced colonic neoplasia was defined as an adenoma that was 10 mm or more in diameter, a villous adenoma, an adenoma with high-grade dysplasia, or invasive cancer. In patients with more than one neoplastic lesion, classification was based on the most advanced lesion. Results Of 17,732 patients screened for enrollment, 3196 were enrolled; 3121 of the enrolled patients (97.7 percent) underwent complete examination of the colon. The mean age of the patients was 62.9 years, and 96.8 percent were men. Colonoscopic examination showed one or more neoplastic lesions in 37.5 percent of the patients, an adenoma with a diameter of at least 10 mm or a villous...
1,827 citations