Colorectal Cancer Screening with Computed Tomography Colonography: Single Region Experience in Kazakhstan
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: The aim of our study was to determine the efficacy of computed tomography colonography (CTC) in screeningfor colorectal cancer (CRC). Methods: A total of 612 females and 588 males aged 45 to 75 years were enrolled in CTC screening. CTC was performed followingstandard bowel preparation and colonic insufflation with carbon dioxide. The main outcomes were the detection rate of CRC andadvanced adenoma (AA), prevalence of colorectal lesions in relation to socio-demographic and health factors, and overall diagnosticperformance of CTC. Results: Overall, 56.5% of the 1,200 invited subjects underwent CTC screening. The sensitivity for CRC and AA was 0.89 and0.97, respectively, while the specificity was 0.71 and 0.99, respectively. The prevalence of CRC and AA was 3.0% (18/593) and 7.1%(42/593), respectively, with the highest CRC prevalence in the 66-75 age group (≥12 times; odds ratio [OR], 12.11; 95% confidenceinterval [CI], 4.45-32.92). CRC and AA prevalence were inversely correlated with Asian descent, physical activity, and negative fecalimmunochemical test results (OR=0.43; 95% CI, 0.22-0.83; OR=0.16; 95% CI, 0.04-0.68; OR=0.5; 95% CI, 0.07-3.85, respectively). Conclusions: Our study revealed high accuracy of CTC in diagnosing colonic neoplasms, good compliance with CTC screening, andhigh detection rate of CRC.
Abstract
Background/Aims: The aim of our study was to determine the efficacy of computed tomography colonography (CTC) in screeningfor colorectal cancer (CRC). Methods: A total of 612 females and 588 males aged 45 to 75 years were enrolled in CTC screening. CTC was performed followingstandard bowel preparation and colonic insufflation with carbon dioxide. The main outcomes were the detection rate of CRC andadvanced adenoma (AA), prevalence of colorectal lesions in relation to socio-demographic and health factors, and overall diagnosticperformance of CTC. Results: Overall, 56.5% of the 1,200 invited subjects underwent CTC screening. The sensitivity for CRC and AA was 0.89 and0.97, respectively, while the specificity was 0.71 and 0.99, respectively. The prevalence of CRC and AA was 3.0% (18/593) and 7.1%(42/593), respectively, with the highest CRC prevalence in the 66-75 age group (≥12 times; odds ratio [OR], 12.11; 95% confidenceinterval [CI], 4.45-32.92). CRC and AA prevalence were inversely correlated with Asian descent, physical activity, and negative fecalimmunochemical test results (OR=0.43; 95% CI, 0.22-0.83; OR=0.16; 95% CI, 0.04-0.68; OR=0.5; 95% CI, 0.07-3.85, respectively). Conclusions: Our study revealed high accuracy of CTC in diagnosing colonic neoplasms, good compliance with CTC screening, andhigh detection rate of CRC.
참고문헌 (39)
- Bray F, "Global cancer statistics 2018 : GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries", CA Cancer J Clin, 68, pp.394~424 (2018)
- Pourhoseingholi MA, "Increased burden of colorectal cancer in Asia", World J Gastrointest Oncol, 4, pp.68~70 (2012)
- Alma Zhylkaidarova, "Trends of Colorectal Cancer Prevalence in Kazakhstan Related to Screening", Clinical Endoscopy, 54(1), pp.32~37 (2021), 대한소화기내시경학회[DOI]
- Okugawa Y, "Epigenetic alterations in colorectal cancer : Emerging Biomarkers", Gastroenterology, 149, pp.1204~1225 (2015)
- Rex DK, "Serrated lesions of the colorectum : review and recommendations from an expert panel", Am J Gastroenterol, 107, pp.1315~1329 (2012)
- Kahi CJ, "Reviewing the evidence that polypectomy prevents cancer", Gastrointest Endosc Clin N Am, 29, pp.577~585 (2019)
- Gupta S, "Recommendations for follow-up after colonoscopy and polypectomy : a consensus update by the us multi-society task force on colorectal cancer", Gastroenterology, 158, pp.1131~1153 (2020)
- Sung JJY, "An updated asia pacific consensus recommendations on colorectal cancer screening", Gut, 64, pp.121~132 (2015)
- Ojidu H, "Patient tolerance and acceptance of different colonic imaging modalities : an observational cohort study", Eur J Gastroenterol Hepatol, 30, pp.520~525 (2018)
- Abu-Freha N, "Should colonoscopy be the primary screening modality for colorectal cancer in israel?", Harefuah, 158, pp.523~528 (2019)
- Kaidarova D, "Colorectal screening in kazakhstan : analysis of accessibility, problems, and prospects for further improvement", Oncol and Rad of Kazakhstan, 1, pp.4~8 (2019)
- Plumb AA, "Sensitivity and specificity of CT colonography for the detection of colonic neoplasia after positive faecal occult blood testing : systematic review and meta-analysis", Eur Radiol, 24, pp.1049~1058 (2014)
- Neri E, "CT colonography versus double-contrast barium enema for screening of colorectal cancer : comparison of radiation burden", Abdom Imaging, 35, pp.596~601 (2010)
- Pickhardt PJ, "Strong evidence in support of CT colonography screening", Lancet Oncol, 13, pp.6~7 (2012)
- Atkin W, "Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer(SIGGAR) : a multicentre randomised trial", Lancet, 381, pp.1194~1202 (2013)
- US Preventive Services Task Force, "Screening for colorectal cancer : us preventive services task force recommendation statement", JAMA, 315, pp.2564~2575 (2016)
- Spada C, "Imaging alternatives to colonoscopy : CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy(ESGE)and European Society of Gastrointestinal and Abdominal Radiology(ESGAR)Guideline-Update 2020", Endoscopy, 52, pp.1127~1141 (2020)
- Sali L, "CT colonography for population screening of colorectal cancer : hints from European trials", Br J Radiol, 89, pp.20160517~ (2016)
- Sali L, "Computed tomographic colonography in subjects with positive faecal occult blood test refusing optical colonoscopy", Dig Liver Dis, 45, pp.285~289 (2013)
- Nagtegaal ID, "The 2019 WHO classification of tumours of the digestive system", Histopathology, 76, pp.182~188 (2020)
- Salmo E, "Adenoma and malignant colorectal polyp : pathological considerations and clinical applications", EMJ Gastroenterol, 7, pp.92~102 (2018)
- Pooler BD, "CT colonography reporting and data system(C-RADS) : benchmark values from a clinical screening program", AJR Am J Roentgenol, 202, pp.1232~1237 (2014)
- Zhu H, "Comparison of the participation rate between CT colonography and colonoscopy in screening population : a systematic review and meta-analysis of randomized controlled trials", Br J Radiol, 93, pp.20190240~ (2020)
- McNamara D, "Round one of the adelaide and meath hospital", trinity college colorectal cancer screening programme : programme report and analysis based on established international key performance indices, 2011, pp.180, 549~552
- Poskus T, "Initial results of the national colorectal cancer screening program in Lithuania", Eur J Cancer Prev, 24, pp.76~80 (2015)
- Rex DK, "Quality indicators for colonoscopy", Gastrointest Endosc, 81, pp.31~53 (2015)
- Amano T, "Number of polyps detected is a useful indicator of quality of clinical colonoscopy", Endosc Int Open, 6, pp.E878~E884 (2018)
- Klair JS, "Serrated polyp detection rate and advanced adenoma detection rate from a US multicenter cohort", Endoscopy, 52, pp.61~67 (2020)
- Karsenti D, "Adenoma and advanced neoplasia detection rates increase from 45 years of age", World J Gastroenterol, 25, pp.447~456 (2019)
- Armaroli P, "European code against cancer, 4th edition: cancer screening", Cancer Epidemiol, 39(Suppl 1), pp.S139~S152 (2015)
- Abdullayev MS, "Epidemiological aspects of colorectal cancer in Kazakhstan", Nov Khirurgii, 25, pp.394~403 (2017)
- Siegel RL, "Cancer statistics, 2019", CA Cancer J Clin, 69, pp.7~34 (2019)
- Kim NH, "Yield of repeat colonoscopy in asymptomatic individuals with a positive fecal immunochemical test and recent colonoscopy", Gastrointest Endosc, 89, pp.1037~1043 (2019)
- Zhou XY, "Association between physical activity and colorectal cancer risk and prognosis : A meta-analysis", Cancer Treatment and Research Communications, 9, pp.62~69 (2016)
- Des Guetz G, "Impact of physical activity on cancer-specific and overall survival of patients with colorectal cancer", Gastroenterol Res Pract, 2013, pp.340851~ (2013)
- Veerappan GR, "Extracolonic findings on CT colonography increases yield of colorectal cancer screening", AJR Am J Roentgenol, 195, pp.677~686 (2010)
- Pooler BD, "Indeterminate but likely unimportant extracolonic findings at screening CT Colonography(C-RADS Category E3) : incidence and outcomes data from a clinical screening program", AJR Am J Roentgenol, 207, pp.996~1001 (2016)
- Tutein Nolthenius CJ, "Computer tomography colonography participation and yield in patients under surveillance for 6-9 mm polyps in a population-based screening trial", Eur Radiol, 26, pp.2762~2770 (2016)
- Johnston BC, "Unprocessed red meat and processed meat consumption : dietary guideline recommendations from the nutritional recommendations(NutriRECS)consortium", Ann Intern Med, 171, pp.756~764 (2019)