دورية أكاديمية
أعرض في EDS

Colorectal cancer screening with fecal immunochemical testing: a community-based, cross-sectional study in average-risk individuals in Nigeria.

التفاصيل البيبلوغرافية
العنوان: Colorectal cancer screening with fecal immunochemical testing: a community-based, cross-sectional study in average-risk individuals in Nigeria.
المؤلفون: Alatise OI; Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Osun, Nigeria; African Research Group for Oncology, Osun, Nigeria., Dare AJ; African Research Group for Oncology, Osun, Nigeria; Department of Surgery, and Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Akinyemi PA; African Research Group for Oncology, Osun, Nigeria., Abdulkareem FB; Department of Anatomic and Molecular Pathology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria., Olatoke SA; Department of Surgery, University of Ilorin Teaching Hospital, Kwara, Nigeria., Knapp GC; African Research Group for Oncology, Osun, Nigeria; Department of Surgery, Division of General Surgery, Dalhousie University, Nova Scotia, Canada., Kingham TP; African Research Group for Oncology, Osun, Nigeria; Department of Surgery, and Global Cancer Disparities Initiative, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address: kinghamt@mskcc.org.
مؤلفون مشاركون: African Research for Oncology Colorectal Screening Early Detection Group
المصدر: The Lancet. Global health [Lancet Glob Health] 2022 Jul; Vol. 10 (7), pp. e1012-e1022.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101613665 Publication Model: Print Cited Medium: Internet ISSN: 2214-109X (Electronic) Linking ISSN: 2214109X NLM ISO Abbreviation: Lancet Glob Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [England] : Elsevier Ltd. 2013-
مواضيع طبية MeSH: Adenoma*/diagnosis , Adenoma*/epidemiology , Colorectal Neoplasms*/diagnosis , Colorectal Neoplasms*/epidemiology, Cross-Sectional Studies ; Early Detection of Cancer/methods ; Female ; Humans ; Male ; Mass Screening/methods ; Middle Aged ; Nigeria/epidemiology
مستخلص: Background: The estimated incidence of colorectal cancer is rising in Nigeria, where most patients present with advanced disease. Earlier detection of colorectal cancer is a goal of the Nigerian National Cancer Control Plan, but the utility of fecal-based screening is unclear. This study aimed to assess the fecal immunochemical test as a colorectal cancer screening modality in average-risk individualS in Nigeria.
Methods: A population-based, cross-sectional study of qualitative fecal immunochemical test-based colorectal cancer screening was done in asymptomatic, average-risk participants aged 45-75 years in three states in Nigeria (Osun, Kwara, and Lagos). Participants were invited to enrol using age-stratified and sex-stratified convenience sampling following community outreach. Exclusion criteria included a personal history of colorectal cancer or rectal bleeding in the previous 6 months, a first-degree relative with a known diagnosis of colorectal cancer, or a comorbidity that would preclude conscious sedation or general anesthesia. Participants with positive fecal immunochemical test results underwent colonoscopy, and the positive predictive value of fecal immunochemical testing for colorectal cancer and advanced adenomas (≥10 mm, tubulovillous or villous or high-grade dysplasia) was calculated. Data on demographics and acceptability of fecal immunochemical testing and colonoscopy were collected.
Findings: Between January and April 2021, 2330 participants were enrolled in the study and received a fecal immunochemical test, which was returned by 2109 participants. 1677 participants tested negative and 432 tested positive. Of these 432 participants, 285 underwent a colonoscopy (235 showed no polyps or cancer, 47 had polyps identified, and three had colorectal cancer identified). Of the 47 participants who had polyps identified, 20 had advanced adenomas diagnosed. The median age was 57 years (IQR 50-63), 958 (41%) were male and 1372 (59%) were female, and 68% had at least a secondary-level education. Participants were evenly spread across wealth quintiles. The positivity rate of the fecal immunochemical test was 21% overall (432 of 2109; 95% CI 20-21%), 11% (51 of 455; 95% CI 10-12) in Lagos, 20% (215 of 1052; 95% CI 20-21) in Osun, and 28% (166 of 597; 95% CI 27-29) in Kwara. Among the patients with a positive fecal immunochemical test who completed colonoscopy, the positive predictive value for invasive colorectal cancer was 1·1% (95% CI 0·3-3·3), and 7·0% (4·5-10·8) for advanced adenoma. The acceptability of fecal immunochemical screening among participants was very high.
Interpretation: Colorectal cancer screening with qualitative fecal immunochemical tests in Nigeria is feasible and acceptable to average-risk asymptomatic participants. However, the low positive predictive value for advanced neoplasia and high endoscopy burden investigating false positives suggests it might not be an appropriate screening tool in this setting.
Funding: Thompson Family Foundation, Prevent Cancer Foundation, National Institutes of Health/National Cancer Institute Program Cancer Center.
Competing Interests: Declaration of interests TPK reports personal fees from Olympus outside of the submitted work. AJD reports consulting fees from Memorial Sloan Kettering Cancer Center during the conduct of this study. All other authors declare no competing interests.
(Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
التعليقات: Comment in: Lancet Glob Health. 2022 Jul;10(7):e938-e939. (PMID: 35714636)
Comment in: Lancet Glob Health. 2022 Nov;10(11):e1561. (PMID: 36240820)
Comment in: Lancet Glob Health. 2022 Nov;10(11):e1562. (PMID: 36240821)
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معلومات مُعتمدة: P30 CA008748 United States CA NCI NIH HHS
فهرسة مساهمة: Investigator: OI Alatise; TP Kingham; FB Abdulkareem; SA Olatoke; AJ Dare; PA Akinyemi; GC Knapp; OR Ademakinwa; AA Adeyeye; OS Agodirin; KB Badmus; MO Bojuwoye; MD Bernardo; R Kahn; AO Lawal; EA Odeghe; SG Ogunleye; OO Olasehinde; OT Olagboyega; C Olcese; AB Olokoba; T Omoyiola; NO Orah; AO Osinowo; GK Oyeleke; IA Owoade; K Randolph; R Tulloch
تواريخ الأحداث: Date Created: 20220617 Date Completed: 20220621 Latest Revision: 20221019
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9400038
DOI: 10.1016/S2214-109X(22)00121-8
PMID: 35714629
قاعدة البيانات: MEDLINE
الوصف
تدمد:2214-109X
DOI:10.1016/S2214-109X(22)00121-8