Subject(s)
Colonic Neoplasms/prevention & control , Mass Screening , Rectal Neoplasms/prevention & control , Sigmoidoscopes , Adult , Colonic Neoplasms/diagnosis , Cost-Benefit Analysis , Evaluation Studies as Topic , Fiber Optic Technology/instrumentation , Global Health , Humans , Longitudinal Studies , Mass Screening/economics , Mass Screening/standards , Middle Aged , Rectal Neoplasms/diagnosis , Risk , Sigmoidoscopy/economics , Sigmoidoscopy/educationSubject(s)
Colonic Neoplasms/diagnosis , Occult Blood , Rectal Neoplasms/diagnosis , Humans , Middle AgedABSTRACT
A randomized, controlled study on occult blood in stool was conducted in 48,000 asymptomatic participants, ages 50 to 80 years. Those with positive hemoccult test results underwent a complete colonic workup including colonoscopy and, in some cases, an air-contrast barium-enema examination when total colonoscopy could not be accomplished. From April 1976 to December 1980, 113 patients (62 men and 51 women), with an average age of 66 years, were found to have invasive carcinomas of the large bowel: right colon--25 per cent, transverse colon (included both flexures)--9 per cent, descending colon--10 percent, sigmoid and rectosigmoid--42 per cent, rectum--12 per cent, anal canal--2 per cent. The stages of the cancers were: Dukes' A--57 per cent, Dukes' B--21 per cent, Dukes' C--19 per cent, Dukes' D--3 per cent. The findings suggest that a complete colonic workup is required for the detection and diagnosis of large-bowel cancers in asymptomatic patients.
Subject(s)
Anus Neoplasms/diagnosis , Colonic Neoplasms/diagnosis , Occult Blood , Rectal Neoplasms/diagnosis , Sigmoid Neoplasms/diagnosis , Aged , Female , Humans , Male , Middle AgedABSTRACT
A long-term clinical study is underway to evaluate the merit of occult stool blood testing in the earlier detection of colorectal cancers; 48,000 participants have been enrolled. Thus far, 873 patients with occult stool blood have been examined, and 77 gastrointestinal cancers have been found in 74 patients. Although data from the control group are not yet available for comparison, most of the cancers found appear to be relatively early in their development. Conventional barium-enema examinations were noted to have "missed" one third of the colon cancers and two-thirds of the colon polyps which were found on colonoscopy. Preliminary results of the study appear encouraging. Definitive analysis will await the availability of additional pertinent data.
Subject(s)
Colonic Neoplasms/diagnosis , Occult Blood , Rectal Neoplasms/diagnosis , Barium Sulfate , Evaluation Studies as Topic , Feces/analysis , Female , Humans , Intestinal Polyps/diagnosis , Male , Proctoscopy , Time FactorsSubject(s)
Breast Neoplasms/diagnosis , Aged , Female , Follow-Up Studies , Humans , Longitudinal Studies , Middle Aged , Prognosis , Time FactorsSubject(s)
Colonic Neoplasms/prevention & control , Occult Blood , Aged , Colonic Neoplasms/diagnosis , Colonic Neoplasms/mortality , Female , Humans , Male , Mass Screening , Middle Aged , MinnesotaSubject(s)
Adenocarcinoma/diagnosis , Colonic Neoplasms/diagnosis , Rectal Neoplasms/diagnosis , Sigmoidoscopy , Barium Sulfate , Colon/diagnostic imaging , Enema , Evaluation Studies as Topic , False Negative Reactions , Fiber Optic Technology , Humans , Radiography , Rectum/diagnostic imaging , Sigmoid Neoplasms/diagnosisABSTRACT
The results of the 25+ year Cancer Detection Center study, including 20,000 participants and 100,000+ patient-years experience, demonstrate the obviation of appearance of most lower bowel cancers associated with a program of proctosigmoidoscopy and adenomatous polyp removal. Once on a schedule of periodic examinations, study participants developed only a fraction of the anticipated number of rectal cancers; most of the cancers which did develop were detected while at an early stage and with involvement of only the mucosa. Not a single death from lower bowel cancer has occurred among active study participants or for 7+ years following the most recent examination at the Center.