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Skrzypczak T, Skrzypczak A, Skrzypczak M. Implications of Public Interest in Colonoscopy: Analysis of Google Trends Data From 12 European Countries. Cureus 2023; 15:e42395. [PMID: 37621831 PMCID: PMC10446506 DOI: 10.7759/cureus.42395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) is one of the deadliest diseases in the European Union. Colonoscopy remains the gold standard of CRC screening. Analysis of colonoscopy-related Google Trends (GT; Google LLC, Mountain View, California, United States) data could provide useful information regarding interest in colonoscopy and potential barriers making patients unwilling to attend screening programs. METHODS Data were collected using GT for the main search term "colonoscopy" and the two most related queries. Colonoscopy volumes were extracted from the Eurostat database. Due to limited Eurostat data availability, analysis was performed from January 2004 to December 2015 for each of the 12 included countries. RESULTS Univariate linear regression analysis demonstrated statistically significant correlations between annual search volumes of "colonoscopy" and the annual number of colonoscopies performed in included countries (R2 = 0.923, P<.001). Trend analysis showed that the cumulative search volumes for "colonoscopy" gradually increased through the analyzed period. The spectrum of the most related queries encompassed "preparation for colonoscopy", "endoscopy", "after endoscopy", "colon", "colonoscopy diet", "virtual colonoscopy", "colonoscopy under anesthesia", "waiting times for colonoscopy" and "colonoscopy price". For eight out of nine queries, statistically significant correlations with procedure volumes were revealed. CONCLUSIONS GT could be a useful tool in assessing public interest in colonoscopy. Potential barriers that prevent people from attending CRC screening programs were identified. The study demonstrated that the internet has become an important field for CRC screening promotion. GT utility for colonoscopy and CRC screening providers was highlighted. This was the first analysis of GT data in colonoscopy focused on European countries.
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Affiliation(s)
| | - Anna Skrzypczak
- Faculty of Dentistry, Wroclaw Medical University, Wroclaw, POL
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Nouni-García R, Lara-López Á, Carratalá-Munuera C, Gil-Guillén VF, López-Pineda A, Orozco-Beltrán D, Quesada JA. Factors Associated with Colorectal Cancer Screening in Spain: Results of the 2017 National Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5460. [PMID: 35564855 PMCID: PMC9100170 DOI: 10.3390/ijerph19095460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 12/03/2022]
Abstract
This study aimed to determine the CRC screening coverage of people aged between 50 and 69 years who were living in Spain in 2017 and describe the factors associated with not having had a faecal occult blood test (FOBT). A cross-sectional study was performed using data from the Spanish National Health Survey 2017. We analysed 7568 individuals between the ages of 50 and 69 years. The proportion of respondents between 50 and 69 years old who had had an FOBT was 29.0% (n = 2191). The three autonomous communities with the lowest proportion of respondents who had had an FOBT were Extremadura (8.7%, n = 16), Ceuta-Melilla (10.4%, n = 3), and Andalucia (14.1%, n = 186). The variables associated with not having had an FOBT were being 50-54 years old (PR = 1.09; 95% CI 1.04-1.14), having been born outside of Spain (PR = 1.11; 95% CI 1.06-1.16), not having been vaccinated against the flu (PR = 1.09; 95% CI 1.04-1.15), never having had a colonoscopy (PR = 1.49; 95% CI 1.40-1.59), not having had an ultrasound scan in the last year (PR = 1.09; 95% CI 1.04-1.14), and not having seen a primary care physician in the last month (PR = 1.08; 95% CI 1.04-1.12). The factors associated with not getting an FOBT were young age, having been born outside of Spain, not having been vaccinated against the flu in the last campaign, and not making frequent use of healthcare services.
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Affiliation(s)
- Rauf Nouni-García
- Department of Clinical Medicine, Miguel Hernández University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain; (R.N.-G.); (C.C.-M.); (V.F.G.-G.); (D.O.-B.); (J.A.Q.)
| | - Ángela Lara-López
- San Juan de Alicante Campus, Faculty of Medicine, Miguel Hernández University, 03202 San Juan de Alicante, Spain;
| | - Concepción Carratalá-Munuera
- Department of Clinical Medicine, Miguel Hernández University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain; (R.N.-G.); (C.C.-M.); (V.F.G.-G.); (D.O.-B.); (J.A.Q.)
| | - Vicente F. Gil-Guillén
- Department of Clinical Medicine, Miguel Hernández University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain; (R.N.-G.); (C.C.-M.); (V.F.G.-G.); (D.O.-B.); (J.A.Q.)
| | - Adriana López-Pineda
- Department of Clinical Medicine, Miguel Hernández University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain; (R.N.-G.); (C.C.-M.); (V.F.G.-G.); (D.O.-B.); (J.A.Q.)
| | - Domingo Orozco-Beltrán
- Department of Clinical Medicine, Miguel Hernández University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain; (R.N.-G.); (C.C.-M.); (V.F.G.-G.); (D.O.-B.); (J.A.Q.)
| | - Jose A. Quesada
- Department of Clinical Medicine, Miguel Hernández University, Ctra. Nnal. 332 Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain; (R.N.-G.); (C.C.-M.); (V.F.G.-G.); (D.O.-B.); (J.A.Q.)
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Vanaclocha-Espi M, Ibáñez J, Molina-Barceló A, Valverde-Roig MJ, Nolasco A, Pérez-Riquelme F, de la Vega M, Portillo I, Salas D. Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex. PLoS One 2021; 16:e0254021. [PMID: 34270590 PMCID: PMC8284629 DOI: 10.1371/journal.pone.0254021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/17/2021] [Indexed: 01/22/2023] Open
Abstract
In the fecal immunological test, a suitable cut-off value may be selected to classify results as either positive or negative. Our aim is to estimate the optimal cut-off value for detecting colorectal cancer in different age and sex groups. This is a multicentric retrospective cohort study of participants in CRC screening programs with FIT between 2006 and 2012. A total of 545,505 participations were analyzed. Cancers diagnosed outside of the program were identified after a negative test result (IC_test) up until 2014. The Wilcoxon test was used to compare fecal hemoglobin levels. ROC curves were used to identify the optimal cut-off value for each age and sex group. Screening program results were estimated for different cut-off values. The results show that the Hb concentration was higher in colorectal cancer (average = 179.6μg/g) vs. false positives (average = 55.2μg/g), in IC_test (average = 3.1μg/g) vs. true negatives (average = 0μg/g), and in men (average = 166.2μg/g) vs. women (average = 140.2μg/g) with colorectal cancer. The optimal cut-off values for women were 18.3μg/g (50-59y) and 14.6μg/g (60-69y), and 16.8μg/g (50-59y) and 19.9μg/g (60-69y) for men. Using different cut-off values for each age and sex group lead to a decrease in the IC_test rate compared to the 20μg/g cut-off value (from 0.40‰ to 0.37‰) and an increase in the false positive rate (from 6.45% to 6.99%). Moreover, test sensitivity improved (90.7%), especially in men and women aged 50-59y (89.4%; 90%) and women aged 60-69y (90.2%). In conclusion, the optimal cut-off value varies for different sex and age groups and the use of an optimal cut-off value for each group improves sensitivity and leads to a small decrease in IC_tests, but also to a larger increase in false positives.
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Affiliation(s)
- Mercedes Vanaclocha-Espi
- Foundation for the Promotion of Health and Biomedical Research-Public Health Research FISABIO–Public Health Research, Valencia, Spain
| | - Josefa Ibáñez
- Foundation for the Promotion of Health and Biomedical Research-Public Health Research FISABIO–Public Health Research, Valencia, Spain
- General Directorate Public Health, Valencian Community, Spain
| | - Ana Molina-Barceló
- Foundation for the Promotion of Health and Biomedical Research-Public Health Research FISABIO–Public Health Research, Valencia, Spain
| | | | | | - Francisco Pérez-Riquelme
- General Directorate of Public Health, Murcia Region, Spain
- Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU), University Hospital “Virgen de la Arrixaca”, University of Murcia, Murcia, Spain
| | | | | | - Dolores Salas
- Foundation for the Promotion of Health and Biomedical Research-Public Health Research FISABIO–Public Health Research, Valencia, Spain
- General Directorate Public Health, Valencian Community, Spain
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Wang A, Lee B, Patel S, Whitaker E, Issaka RB, Somsouk M. Selection of patients for large mailed fecal immunochemical test colorectal cancer screening outreach programs: A systematic review. J Med Screen 2021; 28:379-388. [PMID: 33683155 DOI: 10.1177/0969141321997482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Digital health care offers an opportunity to scale and personalize cancer screening programs, such as mailed outreach for colorectal cancer (CRC) screening. However, studies that describe the patient selection strategy and process for CRC screening are limited. Our objective was to evaluate implementation strategies for selecting patients for CRC screening programs in large health care systems. METHODS We conducted a systematic review of 30 studies along with key informant surveys and interviews to describe programmatic implementation strategies for selecting patients for CRC screening. PubMed and Embase were searched since inception through December 2018, and hand searches were performed of the retrieved reference lists but none were incorporated (n = 0). No language exclusions were applied. RESULTS Common criteria for outreach exclusion included: being up-to-date with routine CRC screening (n = 22), comorbidities (n = 20), and personal history (n = 22) or family history of cancer (n = 9). Key informant surveys and interviews were performed (n = 28) to understand data sources and practices for patient outreach selection, and found that 13 studies leveraged electronic medical care records, 10 studies leveraged a population registry (national, municipal, community, health), 4 studies required patient opt-in, and 1 study required primary care provider referral. Broad ranges in fecal immunochemical test completion were observed in community clinic (n = 8, 31.0-59.6%), integrated health system (n = 5, 21.2-82.7%), and national regional CRC screening programs (n = 17, 23.0-64.7%). Six studies used technical codes, and four studies required patient self-reporting from a questionnaire to participate. CONCLUSION This systematic review provides health systems with the diverse outreach practices and technical tools to support efforts to automate patient selection for CRC screening outreach.
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Affiliation(s)
- Andrew Wang
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Briton Lee
- Department of Medicine, New York University Langone Medical Center, New York, NY, USA
| | - Shreya Patel
- Division of Gastroenterology, University of California, San Francisco, CA, USA
| | - Evans Whitaker
- University of California San Francisco Medical Library, University of California, San Francisco, CA, USA
| | - Rachel B Issaka
- Clinical Research and Public Health Science Divisions, Fred Hutchinson, Seattle, WA, USA.,Division of Gastroenterology, University of Washington, Seattle, WA, USA
| | - Ma Somsouk
- Division of Gastroenterology, University of California, San Francisco, CA, USA.,Center for Vulnerable Populations, University of California, San Francisco, CA, USA
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Toes-Zoutendijk E, Portillo I, Hoeck S, de Brabander I, Perrin P, Dubois C, van Leerdam M, Lansdorp-Vogelaar I, Bardou M. Participation in faecal immunochemical testing-based colorectal cancer screening programmes in the northwest of Europe. J Med Screen 2019; 27:68-76. [PMID: 31645173 PMCID: PMC7222964 DOI: 10.1177/0969141319879712] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective This study compared the participation in four faecal immunochemical testing-based screening programmes for colorectal cancer in Flanders, France, Basque country and the Netherlands, to identify factors to further optimize faecal immunochemical testing programmes. Method Background information and data on performance indicators were collected and compared for the four programmes. Results Invitation method, reminders, funding, faecal immunochemical testing cut-off and follow-up after positive faecal immunochemical testing differed in the four programmes. In France, only an invitation letter is sent by mail, while the sample kit must be collected from the general practitioner. In the other programmes, an invitation letter including the sample kit is sent by mail. Participation rates vary substantially according to the method of invitation, with the highest participation rates in the Netherlands (73.0%) and Basque country (72.4%), followed by Flanders (54.5%) and France (28.6%). Basque country (92.8%) and France (88.4%), the two programmes with most active involvement of general practitioners in referral for colonoscopy, had the highest participation rates for colonoscopy. Conclusions Large differences in screening participation observed between programmes according to the invitation method used suggest that changes to the design of the programme, such as including the sample kit with the invitation, or active involvement of GPs, might increase participation.
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Affiliation(s)
| | | | - Sarah Hoeck
- Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.,Centre for Cancer Detection, Brugge, Belgium
| | | | - Philippe Perrin
- Association pour le déspistage du Cancer Colorectal en Alsace (ADECA), Colmar, France
| | | | - Monique van Leerdam
- Gastroenterology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | | | - Marc Bardou
- Gastroenterology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Clinical Investigation Center INSERM 1432, Dijon-Bourgogne University Hospital, Dijon, France
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Vanaclocha-Espi M, Ibáñez J, Molina-Barceló A, Valverde-Roig MJ, Pérez E, Nolasco A, de la Vega M, de la Lastra-Bosch ID, Oceja ME, Espinàs JA, Font R, Pérez-Riquelme F, Arana-Arri E, Portillo I, Salas D. Risk factors for severe complications of colonoscopy in screening programs. Prev Med 2019; 118:304-308. [PMID: 30414944 DOI: 10.1016/j.ypmed.2018.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/05/2018] [Accepted: 11/07/2018] [Indexed: 02/07/2023]
Abstract
Severe complications (SC) in colonoscopy represent the most important adverse effect of colorectal cancer screening programs (CRCSP). The objective is to evaluate the risk factors for SC in colonoscopy indicated after a positive fecal occult blood test in population-based CRCSP. The SC (n = 161) identified from 48,730 diagnostic colonoscopies performed in a cohort of all the women and men invited from 2000 to 2012 in 6 CRCSP in Spain. A total of 318 controls were selected, matched for age, sex and period when the colonoscopy was performed. Conditional logistic regression models were estimated. The analysis was performed separately in groups: immediate-SC (same day of the colonoscopy); late-SC (between 1 and 30 days after); perforation; and bleeding events. SC occurred in 3.30‰ of colonoscopies. Prior colon disease showed a higher risk of SC (OR = 4.87). Regular antiplatelet treatment conferred a higher risk of overall SC (OR = 2.80) and late-SC (OR = 9.26), as did regular anticoagulant therapy (OR = 3.47, OR = 7.36). A history of pelvic-surgery or abdominal-radiotherapy was a risk factor for overall SC (OR = 5.03), immediate-SC (OR = 8.49), late-SC (OR = 4.65) and perforation (OR = 21.59). A finding of adenoma or cancer also showed a higher risk of overall SC (OR = 8.71), immediate-SC (OR = 12.67), late-SC (OR = 4.08), perforation (OR = 4.69) and bleeding (OR = 17.02). The risk of SC doesn't vary depending on the type of preparation or type of anesthesia. Knowing the clinical history of patients such as regular previous medication and history of surgery or radiotherapy, as well as the severity of the findings during the colonoscopy process could help to focus prevention measures in order to minimize SC in CRCSP.
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Affiliation(s)
| | - Josefa Ibáñez
- Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain; General Directorate Public Health, Valencian Community, Spain
| | | | | | - Elena Pérez
- General Directorate Public Health, Valencian Community, Spain
| | | | | | | | | | - Josep Alfons Espinàs
- Catalan Cancer Strategy, Department of Health, Catalonia, Spain; Biomedical Research Institute, Bellvitge, (IDIBELL) - L'Hospitalet de LLob, Barcelona, Spain
| | - Rebeca Font
- Catalan Cancer Strategy, Department of Health, Catalonia, Spain; Biomedical Research Institute, Bellvitge, (IDIBELL) - L'Hospitalet de LLob, Barcelona, Spain
| | - Francisco Pérez-Riquelme
- General Directorate Public Health, Murcia, Spain; Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU), University Clinical Hospital Virgen de la Arrixaca, University of Murcia, Spain
| | | | | | - Dolores Salas
- Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain; General Directorate Public Health, Valencian Community, Spain.
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