Anderson / Kahi / MD Colorectal Cancer Screening

1. Auflage 2011
ISBN: 978-1-60761-398-5
Verlag: Humana Press
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 205 Seiten

Reihe: Clinical Gastroenterology

Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening as well as increasing patient participation is presentedd. For the subspecialist, information regarding the latest imaging techniques as well as flat adenomas and chromoendoscopy are covered. The section on the molecular changes in CRC will appeal to both groups. The text includes up to date information about colorectal screening that encompasses the entire spectrum of the topic and features photographs of polyps as well as diagrams of the morphology of polyps as well as photographs of CT colonography images. Algorithms are presented for all the suggested guidelines.

Chapters are devoted to patient participation in screening and risk factors as well as new imaging technology. This useful volume explains the rationale behind screening for CRC. In addition, it covers the different screening options as well as the performance characteristics, when available in the literature, for each test. This volume will be used by the sub specialists who perform screening tests as well as primary care practitioners who refer patients to be screened for colorectal cancer.

Autoren/Hrsg.

Anderson, Md

Anderson, Joseph

Kahi, Md

MD,

Kahi, Charles

Inhaltsverzeichnis

1;Preface;6
2;Contents;8
3;Contributors;10
4;Chapter 1: Colorectal Cancer Pathways;12
4.1;Chromosomal Instability or Suppressor Pathways;13
4.2;Microsatellite Instability or Mutator Pathway;13
4.3;CpG Island Methylator Pathway;16
4.4;References;16
5;Chapter 2: Risk Factors and Screening for Colorectal Cancer;18
5.1;Prospective Studies;18
5.2;Risk Factors;20
5.2.1;Red Meat;20
5.2.2;Fiber Intake;21
5.2.3;Physical Exertion;21
5.2.4;Gender;22
5.2.5;Alcohol;22
5.2.6;Tobacco;23
5.2.7;Obesity;23
5.2.8;Diabetes Mellitus;24
5.2.9;Race;24
5.3;Asymptomatic Screening Populations;25
5.4;Translation into Screening;26
5.4.1;Models;26
5.4.2;Screening Guidelines;27
5.4.3;New Problems in Screening;27
5.5;References;28
6;Chapter 3: Hereditary Adenomatous Colorectal Cancer Syndromes;35
6.1;Background;35
6.2;Recognizing the Patient with a HCCS;36
6.2.1;Hereditary Nonpolyposis Colorectal Cancer (HNPCC);37
6.2.1.1;Genetics;37
6.2.1.2;Clinical Presentation;39
6.2.1.3;Diagnosis;40
6.2.1.4;Colon Cancer Surveillance;41
6.2.1.5;Extracolonic Screening and Management;41
6.2.2;Familial Adenomatous Polyposis;41
6.2.2.1;Genetics;42
6.2.2.2;Clinical Presentation;42
6.2.2.3;Diagnosis;44
6.2.2.4;Colon Cancer Screening and Surveillance;44
6.2.2.5;Extracolonic Screening and Surveillance;45
6.2.3;MYH-Associated Polyposis (MAP);46
6.2.3.1;Genetics;46
6.2.3.2;Clinical Presentation;46
6.2.3.3;Screening and Surveillance;47
6.3;Conclusions;47
6.4;References;47
7;Chapter 4: Screening and Surveillance Guidelines;52
7.1;Background;52
7.2;Colorectal Cancer Screening;53
7.2.1;Best Evidence for CRC Screening;53
7.2.2;History of Screening Guidelines;54
7.2.3;Current Recommendations for Average Risk Screening;55
7.2.4;High Risk Screening;56
7.2.4.1;Family History;56
7.2.5;Tailored Screening;58
7.2.5.1;Race;59
7.2.5.2;Gender;59
7.2.5.3;Tobacco;59
7.2.5.4;Diabetes Melitus;60
7.3;Surveillance;60
7.3.1;Background;60
7.3.2;Personal History of Adenomas;61
7.3.3;Personal History of Colorectal Cancer;62
7.4;References;63
8;Chapter 5: Barriers to Colorectal Cancer Screening: Patient, Physician, and System Factors;65
8.1;Patient Barriers to CRC Screening;66
8.2;Provider Barriers to CRC Screening;69
8.3;Systems Barriers to CRC Screening;71
8.4;Reducing Barriers to CRC Screening;71
8.5;References;72
9;Chapter 6: Screening for Colorectal CancerUsing Colonoscopy;75
9.1;Rationale and Efficacy for Screening Colonoscopy;75
9.2;Failures of Colonoscopy to Prevent Proximal Colon Cancer;78
9.3;Maximizing Colorectal Cancer Prevention During Colonoscopy;83
9.4;Conclusions;84
9.5;References;84
10;Chapter 7: New Colonoscopic Technologies for Colorectal Cancer Screening;88
10.1;Introduction;88
10.2;Technologies for Improving Detection During Colonoscopy;89
10.2.1;Improving Mucosal Exposure;89
10.2.2;Imaging Technologies for Flat Lesions;91
10.3;Technologies That Allow Real-Time Histology;94
10.4;Conclusions;97
10.5;References;97
11;Chapter 8: Screening for CRC Using CT Colonography*;102
11.1;Introduction;102
11.2;Current Status of CT Colonography;103
11.3;Guidelines and Recommendations;106
11.4;Current Indications for CT Colonograpy;108
11.4.1;CRC Screening of Asymptomatic, Normal-Risk Adults;109
11.4.2;Failed Colonoscopy;111
11.4.3;Evaluation of Colon Proximal to an Obstructing Lesion;111
11.4.4;CRC Screening in Patients with Contraindications to Colonoscopy or Who Refuse Other Screening Options;112
11.5;Contraindications for CT Colonograpy;112
11.6;Qualifications and Training of Personnel;113
11.6.1;CT Scanning;113
11.6.2;Skill and Training to Interpret CT Colonography;113
11.7;Exam and Equipment Specifications;116
11.7.1;Colonic Preparation;116
11.7.2;CT Acquisition Technique;117
11.8;CT Colonography Interpretation and Polyp Reporting;118
11.8.1;Intracolonic Findings;118
11.8.2;Extracolonic Findings;120
11.9;Potential for Increased Screening Uptake;120
11.10;Integration of CT Colonogrpahy with Colonoscopy;121
11.11;Conclusions;121
11.12;References;122
12;Chapter 9: Noninvasive Screening Tests;129
12.1;Introduction;129
12.2;Guaiac-Based Fecal Occult Blood Testing (FOBT);131
12.2.1;Test Mechanism;131
12.2.2;Tests Characteristics;131
12.2.3;Mortality Reduction;133
12.2.4;Population-Based Screening Programs;135
12.3;Immunochemical Fecal Occult Blood Tests;136
12.3.1;Test Mechanism;136
12.3.2;Test Characteristics;137
12.3.3;Quantitative FIT;138
12.3.4;FIT vs. g-FOBT;139
12.3.5;Comparative Performance of Various FITs;141
12.3.6;Sequential Stool Testing;144
12.3.7;Implementing FIT Screening;144
12.3.8;Current Guidelines (Table 9.2);145
12.4;Fecal DNA Testing;146
12.4.1;Background;146
12.4.2;A Multicomponent Fecal DNA Assay;146
12.4.3;Other Fecal DNA Markers;148
12.4.4;What Is the Place of Fecal DNA Testing in ColorectalCancer Screening?;150
12.5;Blood-Based Screening Tests;150
12.5.1;Background;150
12.6;References;152
13;Chapter 10: Removal of Difficult Colon Polyps;157
13.1;Benign or Malignant?;158
13.2;Chromoendoscopy;159
13.3;General Criteria for Removal;161
13.4;Does the Patient Need Hospitalization?;162
13.5;Equipment for Polypectomy of the Difficult Polyp;163
13.6;Broad-Based Polyp (Is or IIa,b,c, LST);164
13.7;The Nonlifting Sign;166
13.8;Configuration;166
13.9;Removal of Air to More Easily Capture a Polyp;168
13.10;Endoscopic Submucosal Dissection (ESD);168
13.11;Bleeding During Polypectomy (Immediate Bleeding);169
13.12;The Argon Plasma Coagulator;169
13.13;Plastic Cap on Endoscope;172
13.14;Accessories;172
13.15;Localization of Polypectomy Site;173
13.16;Retrieval of Specimens;174
13.17;What are the Limits of Colonoscopic Polypectomy?;175
13.18;The Malignant Polyp;176
13.19;Safety and Complications;177
13.20;Summary;178
13.21;References;179
14;Chapter 11: Screening for Colorectal Cancer in the Elderly;183
14.1;The Broad Perspective;183
14.2;Yield and Risks of Colonoscopy in the Elderly;184
14.3;Life Expectancy and Screening Outcomes;185
14.4;Screening Decisions;187
14.5;References;190
15;Chapter 12: Chemoprevention;192
15.1;Introduction;192
15.2;Nutrition;192
15.3;Obesity;193
15.4;Red Meat and Processed Meats;194
15.5;Fruits and Vegetables;194
15.6;Fiber;195
15.7;Calcium and Vitamin D;196
15.8;Folate;197
15.9;Antioxidants;198
15.10;Pharmaceuticals;199
15.10.1;Aspirin;199
15.10.2;Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and Cyclooxygenase 2 (COX-2) Inhibitors;200
15.10.3;Statins;201
15.11;Hormone Replacement Therapy (HRT);202
15.12;References;202
16;Index;206