ABSTRACT
Background Colorectal cancer is the third most common cancer worldwide. Screening with several methods can accurately detect early-stage cancer and polyps and reduce colorectal cancer mortality in adults aged 50 to 75 years. Objective Test the feasibility, interest and potential impact of a colorectal cancer screening in Swiss community pharmacies. Setting 771 community pharmacies of Switzerland participated in a 6-week campaign. Method The pharmacists evaluated the risk factors through a questionnaire among individuals aged between 50 to 75 years old who did not have had a colonoscopy over the previous 10 years. Pharmacists delivered a Faecal Immunochemical Test (FIT) to those without risk. Patients with identified risk factors or with a positive result were referred to a physician. Patients with a negative result were given lifestyle advice and invited for a new screening in two years. Main outcome measure The impact was measured through the number of persons screened, of tests delivered and of referrals to a physician performed. Results Within 6 weeks, 23,024 persons were screened in pharmacies. In total, 760 patients (3%) had risk factors and were directly referred to physicians. The remaining 22,264 received a FIT, and 97% of these individuals performed and sent the FIT to the laboratory. Of the 21,701 tests analysed, 93% were negative. All individuals with positive results (7%) were referred to a physician. Conclusion Having the opportunity to take colorectal cancer prevention measures with a low threshold, like in a community pharmacy encourages the population to perform the screening.
Subject(s)
Colorectal Neoplasms/diagnosis , Community Pharmacy Services/organization & administration , Mass Screening/methods , Pharmacists/organization & administration , Aged , Colorectal Neoplasms/prevention & control , Diagnostic Tests, Routine/methods , Early Detection of Cancer/methods , Feces/chemistry , Female , Humans , Life Style , Male , Middle Aged , Referral and Consultation/statistics & numerical data , Risk Factors , Surveys and Questionnaires , SwitzerlandABSTRACT
It was the aim of this study to develop a nanoparticulate oral drug delivery system for leuprolide based on polyacrylic acid (PAA). In order to achieve formation of nanoparticles in a mild, aqueous environment, two different techniques were combined, namely hydrophobic ion pairing between leuprolide and sodium dodecyl sulphate in a first step, followed by encapsulation into nanoparticles gained by interpolymer complexation between polyacrylic acid and Pluronic F68. The obtained nanoparticles were characterized regarding particle size distribution, drug encapsulation efficiency and in vitro release profile. Additionally, the pharmacokinetic profiles of leuprolide after oral administration of PAA-nanoparticulate and PAA-control tablets to male Sprague-Dawley rats were assessed and compared. It could be shown, that hydrophobic ion pairing increased encapsulation efficacy of leuprolide and leads to a slowed drug release of nanoparticulate suspensions. Relative oral bioavailability of leuprolide could be increased by nanoparticulate tablets up to 4.2-fold. Results verify that the suggested approach is a promising strategy for the design of oral delivery systems for oral administration of peptide drugs.
