Colorectal Cancer Screening Facts
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American Cancer Society Flufobt Program Implementation Guide for Primary Care Practices
Health Care Solutions From the American Cancer Society American Cancer Society FluFOBT Program Implementation Guide for Primary Care Practices EIGHTY BY 2018 Reaching 80% screened for colorectal cancer by 2018 Table of Contents Introduction ................................................................................................................................. 2 Background Information and Education .................................................................................... 3 Why Have a FluFOBT Program? .................................................................................................. 4 Colorectal Cancer Screening Eligibility ...................................................................................... 5 Colorectal Cancer Screening Recommendations ....................................................................... 6 Patient Education ......................................................................................................................... 8 How to Set Up Your FluFOBT Program .................................................................................... 10 Staff Training for Your FluFOBT Program ................................................................................ 16 Summary ..................................................................................................................................... 19 Appendix A: FluFOBT Components and Logic Model ............................................................ 20 Appendix B: Colorectal Cancer Screening Recommendations -
(NCCN Guidelines®) Colorectal Cancer Screening
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Colorectal Cancer Screening Version 2.2017 — November 14, 2017 NCCN.org Continue Version 2.2017, 11/14/17 © National Comprehensive Cancer Network, Inc. 2017, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN® NCCN Guidelines Version 2.2017 Panel Members NCCN Guidelines Index Table of Contents Colorectal Cancer Screening Discussion * Dawn Provenzale, MD, MS/Chair ¤ Þ Michael J. Hall, MD, MS † ∆ Robert J. Mayer, MD † Þ Duke Cancer Institute Fox Chase Cancer Center Dana-Farber/Brigham and Women’s Cancer Center * Samir Gupta, MD/Vice-chair ¤ Amy L. Halverson, MD ¶ UC San Diego Moores Cancer Center Robert H. Lurie Comprehensive Cancer Reid M. Ness, MD, MPH ¤ Center of Northwestern University Vanderbilt-Ingram Cancer Center Dennis J. Ahnen, MD ¤ University of Colorado Cancer Center Stanley R. Hamilton, MD ≠ Scott E. Regenbogen, MD ¶ The University of Texas University of Michigan Travis Bray, PhD ¥ MD Anderson Cancer Center Comprehensive Cancer Center Hereditary Colon Cancer Foundation Heather Hampel, MS, CGC ∆ Niloy Jewel Samadder, MD ¤ Daniel C. Chung, MD ¤ ∆ The Ohio State University Comprehensive Huntsman Cancer Institute at the Massachusetts General Hospital Cancer Center - James Cancer Hospital University of Utah Cancer Center and Solove Research Institute Moshe Shike, MD ¤ Þ Gregory Cooper, MD ¤ Jason B. Klapman, MD ¤ Memorial Sloan Kettering Cancer Center Case Comprehensive Cancer Center/ Moffitt Cancer Center University Hospitals Seidman Cancer Thomas P. Slavin Jr, MD ∆ Center and Cleveland Clinic Taussig David W. Larson, MD, MBA¶ City of Hope Comprehensive Cancer Institute Mayo Clinic Cancer Center Cancer Center Dayna S. -
High Quality Fecal Occult Blood Testing (FOBT) for CRC Screening: Evidence and Recommendations
High Quality Fecal Occult Blood Testing (FOBT) for CRC Screening: Evidence and Recommendations Rationale for use of FOBT High sensitivity fecal occult blood testing (FOBT) is one of the colorectal cancer screening methods recommended in guidelines from the American Cancer Society, the US Preventive Services Taskforce, and every other major medical organization. In spite of this widespread endorsement, primary care clinicians often express conviction that colonoscopy is the “gold standard” test for colorectal cancer screening and that the use of FOBT represents sub-standard care. These beliefs persist in spite of well-documented shortcomings of endoscopy (missed adenomas and cancers, higher complication rates and higher one-time costs than other screening methodologies), and the fact that access to endoscopy is limited or non- existent for a significant proportion of the U.S. population. Many clinicians are also unaware that randomized controlled trials of FOBT screening have demonstrated decreases in colorectal cancer incidence and mortality, and modeling studies suggest that the years of life saved through a high quality FOBT screening program are essentially the same as with a high quality colonoscopy based screening programs. Recent advances in stool blood screening include the emergence of new tests and improved understanding of the impact of quality factors on testing outcomes. This document provides state-of-the-science information about high quality stool testing. Types of Fecal Occult Blood Tests Two main types of FOBT are available – guaiac and immunochemical. Both types of FOBT have been shown to have reasonably high detection rates for colon and rectal cancers; adenoma detection rates are appreciably lower. -
Serous Papillary Adenocarcinoma of Unknown Primary in a Recurrent Paravaginal Cyst
Hindawi Case Reports in Obstetrics and Gynecology Volume 2019, Article ID 8125129, 4 pages https://doi.org/10.1155/2019/8125129 Case Report Serous Papillary Adenocarcinoma of Unknown Primary in a Recurrent Paravaginal Cyst Khilen Patel , Advaita Punjala-Patel, Angela Stephens, and John Lue Department of Obstetrics and Gynecology, Augusta University, Medical College of Georgia, 1120 15th St., Augusta, GA 30912, USA Correspondence should be addressed to Khilen Patel; [email protected] Received 14 February 2019; Revised 1 May 2019; Accepted 28 May 2019; Published 10 June 2019 Academic Editor: Giampiero Capobianco Copyright © 2019 Khilen Patel et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Cystic lesions located in the paravaginal region are rare. When present, paravaginal cysts are typically benign and are incidentally found on routine gynecological exams; however, rarely they can be malignant. Treatment options for paravaginal cancers are not well studied and early diagnosis may help improve prognosis in these patients. Our case describes a 55-year-old female with a recurrent paravaginal cyst that was remarkable for serous papillary adenocarcinoma despite biopsy and fuid cytology negative for malignancy. Tis case demonstrates that malignancy should be considered highly with a recurrent paravaginal cyst, especially when present over a short interval. 1. Introduction due to postmenopausal symptoms and denied any vaginal bleeding or vaginal discharge. On bimanual examination, the Large paravaginal cysts are rare and when present are most uterus and cervix were noted to be surgically absent; however, commonlybenign.Tesecystscanbeeithercongenitalor alargepelvicmasswaspalpated.Tismasswassmooth, acquired. -
Board Review from ACP MEDICINE
BOARD REVIEW FROM MEDSCAPE Case-Based InternalInternal Medicine Self-Assessment Questions CLINICAL ESSENTIALS CARDIOVASCULAR MEDICINE DERMATOLOGY ENDOCRINOLOGY GASTROENTEROLOGY HEMATOLOGY IMMUNOLOGY/ALLERGY INFECTIOUS DISEASE INTERDISCIPLINARY MEDICINE METABOLISM NEPHROLOGY NEUROLOGY ONCOLOGY PSYCHIATRY RESPIRATORY MEDICINE RHEUMATOLOGY www.acpmedicine.com BOARD REVIEW FROM MEDSCAPE Case-Based Internal Medicine Self-Assessment Questions Director of Publishing Cynthia M. Chevins Director, Electronic Publishing Liz Pope Managing Editor Erin Michael Kelly Development Editors Nancy Terry, John Heinegg Senior Copy Editor John J. Anello Copy Editor David Terry Art and Design Editor Elizabeth Klarfeld Electronic Composition Diane Joiner, Jennifer Smith Manufacturing Producer Derek Nash © 2005 WebMD Inc. All rights reserved. No part of this book may be reproduced in any form by any means, including photocopying, or translated, trans- mitted, framed, or stored in a retrieval system other than for personal use without the written permission of the publisher. Printed in the United States of America ISBN: 0-9748327-7-4 Published by WebMD Inc. Board Review from Medscape WebMD Professional Publishing 111 Eighth Avenue Suite 700, 7th Floor New York, NY 10011 1-800-545-0554 1-203-790-2087 1-203-790-2066 [email protected] The authors, editors, and publisher have conscientiously and carefully tried to ensure that recommended measures and drug dosages in these pages are accurate and conform to the standards that prevailed at the time of publication. The reader is advised, however, to check the product information sheet accompanying each drug to be familiar with any changes in the dosage schedule or in the contra- indications. This advice should be taken with particular seriousness if the agent to be administered is a new one or one that is infre- quently used. -
Management of Locally Advanced Rectal Adenocarcinoma Oncology Board Review Manual
ONCOLOGY BOARD REVIEW MANUAL STATEMENT OF EDITORIAL PURPOSE Management of Locally The Hospital Physician Oncology Board Review Advanced Rectal Manual is a study guide for fellows and practicing physicians preparing for board examinations in oncology. Each manual reviews a topic essential Adenocarcinoma to the current practice of oncology. PUBLISHING STAFF Contributors: Nishi Kothari, MD PRESIDENT, GROUP PUBLISHER Assistant Member, Department of Gastrointestinal Bruce M. White Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL SENIOR EDITOR Khaldoun Almhanna, MD, MPH Robert Litchkofski Associate Member, Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research EXECUTIVE VICE PRESIDENT Institute, Tampa, FL Barbara T. White EXECUTIVE DIRECTOR OF OPERATIONS Jean M. Gaul Table of Contents Introduction .............................1 Clinical Evaluation and Staging ..............2 Management .............................4 NOTE FROM THE PUBLISHER: This publication has been developed with Surveillance and Long-Term Effects ..........8 out involvement of or review by the Amer ican Board of Internal Medicine. Conclusion ..............................9 Board Review Questions ...................10 References .............................10 Hospital Physician Board Review Manual www.turner-white.com Management of Locally Advanced Rectal Adenocarcinoma ONCOLOGY BOARD REVIEW MANUAL Management of Locally Advanced Rectal Adenocarcinoma Nishi Kothari, MD, and Khaldoun Almhanna, MD, MPH INTRODUCTION ence to -
Grading Evidence
Grading Evidence Analysis of the colonoscopic findings in patients with rectal bleeding according to the pattern of their presenting symptoms Journal Diseases of the Colon & Rectum Publisher Springer New York ISSN 0012-3706 (Print) 1530-0358 (Online) Issue Volume 34, Number 5 / May, 1991 Abstract Patients presenting with rectal bleeding were prospectively categorized according to the pattern of their presentation into those with outlet bleeding (n=115), suspicious bleeding (n=59), hemorrhage (n=27), and occult bleeding (n=68). All patients underwent colonoscopy and this was complete in 94 percent. There were 34 patients with carcinoma and 69 with adenomas >1 cm diameter. The percentage of neoplasms proximal to the splenic flexure was 1 percent in outlet bleeding, 24 percent with suspicious bleeding, 75 percent with hemorrhage, and 73 percent with occult bleeding. Barium enema was available in 78 patients and was falsely positive for neoplasms in 21 percent and falsely negative in 45 percent. Colonoscopy is the investigation of choice in patients with suspicious, occult, or severe rectal bleeding. Bleeding of a typical outlet pattern may be investigated by flexible sigmoidoscopy. J Surg Res. 1993 Feb;54(2):136-9. Colonoscopy for intermittent rectal bleeding: impact on patient management. Graham DJ, Pritchard TJ, Bloom AD. Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106. Abstract Rectal bleeding is a frequent presenting symptom of a number of benign anorectal disorders. However, it may also be a warning sign of more significant gastrointestinal pathology. For this reason, full colonic evaluation has been recommended in patients with intermittent bright red rectal bleeding. -
Colorectal Cancer Screening
| PATIENT RESOURCE | Colorectal Cancer Screening You have choices when it comes to colorectal cancer screening The best test is the one that gets done * Colonoscopy Multi-target Stool DNA Test* FIT/FOBT (visual exam) (Cologuard®) (fecal immunochemical test/ fecal occult blood test) Uses a scope to look for and Finds abnormal DNA and Detects blood in How does it work? remove abnormal growths blood in the stool sample the stool sample in the colon/rectum Who is it for? Adults starting at age 45 Adults starting at age 45 Adults starting at age 45 How often? Every 10 years† Every 3 years Once a year Moderately invasive, done at Yes, done at home Yes, done at home Non-invasive? hospital or doctor office Yes, however preps have greatly No No/Yes‡ Prep required? improved in recent years Prep: night before Time to collect and mail sample Time to collect and mail sample Time it takes? Procedure: next day Covered?§ Covered by most insurers Covered by most insurers Covered by most insurers Abnormal growths (polyps) If positive, a follow-up If positive, a follow-up removed during colonoscopy Next steps colonoscopy is needed colonoscopy is needed » for evaluation *All positive results on non-colonoscopy screening tests should be followed up with a timely colonoscopy. †For adults at high risk, testing may be more frequent and should be discussed with your health care provider. ‡FIT does not require changes to diet or medication. FOBT requires changes to diet or medication. §Insurance coverage can vary; only your insurer can confirm how colon cancer screening would be covered under your insurance policy. -
CASE FILES® Family Medicine
SECOND EDITION CASE FILES® Family Medicine Eugene C. Toy, MD The John S. Dunn, Senior Academic Chair and Program Director The Methodist Hospital Obstetrics and Gynecology Residency Program Houston, Texas Vice Chair of Academic Affairs Department of Obstetrics and Gynecology The Methodist Hospital–Houston Associate Clinical Professor and Clerkship Director Department of Obstetrics and Gynecology University of Texas Medical School at Houston Houston, Texas Donald Briscoe, MD Director, Family Medicine Residency Program and Chair, Department of Family Medicine The Methodist Hospital—Houston Medical Director Houston Community Health Centers, Inc. Houston, Texas Bruce Britton, MD Clinical Associate Professor and Family Medicine Clerkship Director Department of Family and Community Medicine Eastern Virginia Medical School Portsmouth, Virginia Bal Reddy, MD Director of Predoctoral Education Assistant Professor Department of Family Medicine University of Texas Medical School at Houston Houston, Texas New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2010 by The McGraw-Hill Companies, Inc. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. ISBN: 978-0-07-160024-8 MHID: 0-07-160024-8 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-160023-1, MHID: 0-07-160023-X. All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occur- rence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. -
Colorectal Cancer Tests Save Lives: the Best Test Is the Test That Gets Done
November 2013 Colorectal Cancer Tests Save Lives The best test is the test that gets done Colorectal cancer (CRC) is the second leading cancer killer of men and women in the US, following lung cancer. The US Preventive Services Task Force (USPSTF) recommends three CRC screening tests that are effective 90% at saving lives: colonoscopy, stool tests (guaiac fecal occult About 90% of people live 5 or more blood test-FOBT or fecal immunochemical test-FIT), and years when their colorectal cancer sigmoidoscopy (now seldom done). is found early through testing. Testing saves lives, but only if people get tested. Studies show that people who are able to pick the test they prefer are more likely to actually get the test done. Increasing the use of all recommended colorectal cancer tests can save 1 in 3 more lives and is cost-effective. To increase testing, doctors, nurses, and health About 1 in 3 adults systems can: (23 million) between 50 and ◊ Offer all recommended test options with advice about each. 75 years old is not getting tested as recommended. ◊ Match patients with the test they are most likely to complete. ◊ Work with public health professionals to: ■ Get more adults tested by hiring and training “patient navigators,” who are staff that help people 1 in 10 learn about, get scheduled for, and get procedures done like colonoscopy. 10% of adults who got tested for colorectal cancer ■ Create ways to make it easier for people to get used an effective at-home FOBT/FIT kits in places other than a doctor’s office, stool test. -
Case 18-2004: a 61-Year-Old Man with Rectal Bleeding and a 2-Cm Mass in the Rectum
The new england journal of medicine case records of the massachusetts general hospital Founded by Richard C. Cabot Nancy Lee Harris, m.d., Editor Jo-Anne O. Shepard, m.d., Associate Editor Stacey M. Ellender, Assistant Editor Sally H. Ebeling, Assistant Editor Christine C. Peters, Assistant Editor Case 18-2004: A 61-Year-Old Man with Rectal Bleeding and a 2-cm Mass in the Rectum Paul C. Shellito, M.D., Jeffrey W. Clark, M.D., Christopher G. Willett, M.D., and Aaron P. Caplan, M.D. presentation of case From the Department of Surgery (P.C.S.), A 61-year-old man was referred to this hospital for treatment of a low rectal adenocar- the Hematology–Oncology Unit, Depart- cinoma. He had been well until five months previously, when he occasionally began to ment of Medicine (J.W.C.), the Department of Radiation Oncology (C.G.W.), and the note blood in his stool. A stool guaiac test was positive. Three weeks before the patient’s Department of Pathology (A.P.C.), Massa- referral, a colonoscopy was performed at another hospital. A sessile polyp, 10 mm in chusetts General Hospital; and the De- diameter, was removed from the right side of the colon and was determined to be a tu- partments of Surgery (P.C.S.), Medicine (J.W.C.), Radiation Oncology (C.G.W.), bular adenoma; a sessile polyp, 4 mm in diameter, was found 80 cm into the left side of and Pathology (A.P.C.), Harvard Medical the colon; it was excised and found to be associated with a hyperplastic polyp containing School. -
(NCCN Guidelines®) Colorectal Cancer Screening
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Colorectal Cancer Screening Version 1.2015 NCCN.org Continue Version 1.2015, 06/01/15 © National Comprehensive Cancer Network, Inc. 2015, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN® NCCN Guidelines Version 1.2015 Panel Members NCCN Guidelines Index Colorectal Screening TOC Colorectal Cancer Screening Discussion * Dawn Provenzale, MD, MS/Chair ¤ Þ Francis M. Giardiello, MD, MBA ¤ Patrick M. Lynch, MD, JD ¤ Duke Cancer Institute The Sidney Kimmel Comprehensive The University of Texas Cancer Center at Johns Hopkins MD Anderson Cancer Center * Kory Jasperson, MS, CGC/Vice-chair/Lead ∆ Huntsman Cancer Institute Samir Gupta, MD ¤ Robert J. Mayer, MD † Þ at the University of Utah UC San Diego Moores Cancer Center Dana-Farber/Brigham and Women’s Cancer Center Dennis J. Ahnen, MD ¤ Amy L. Halverson, MD ¶ University of Colorado Cancer Center Robert H. Lurie Comprehensive Cancer Reid M. Ness, MD, MPH ¤ Center of Northwestern University Vanderbilt-Ingram Cancer Center Harry Aslanian, MD ¤ Yale Cancer Center/ Stanley R. Hamilton, MD ≠ M. Sambasiva Rao, MD ≠ ¤ Smilow Cancer Hospital The University of Texas Robert H. Lurie Comprehensive Cancer MD Anderson Cancer Center Center of Northwestern University Travis Bray, PhD ¥ Hereditary Colon Cancer Foundation Heather Hampel, MS, CGC ∆ Scott E. Regenbogen, MD ¶ The Ohio State University Comprehensive University of Michigan Jamie A. Cannon, MD ¶ Cancer Center - James Cancer Hospital Comprehensive Cancer Center University of Alabama at Birmingham and Solove Research Institute Comprehensive Cancer Center Moshe Shike, MD ¤ Þ Mohammad K.