J J Y Sung1, S C Ng2, F K L Chan2, H M Chiu3, H S Kim4, T Matsuda5, S S M Ng6, J Y W Lau6, S Zheng7, S Adler8, N Reddy9, K G Yeoh10, K K F Tsoi11, J Y L Ching12, E J Kuipers13, L Rabeneck14, G P Young15, R J Steele16, D Lieberman17, K L Goh18. 1. Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong. 2. Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong. 3. Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. 4. Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea. 5. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. 6. Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 7. Cancer Institute, Zhejiang University, Hanggzhou, Zhejiang, China. 8. Division of Gastroenterology, Bikur Holim Hospital, Jerusalem, Israel. 9. Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India. 10. Department of Medicine, Asian Healthcare Foundation, National University of Singapore and Senior Consultant Gastroenterologist, Singapore. 11. School of Public Health & Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 12. Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Hong Kong. 13. Department of Medicine & Therapeutics, Erasmus University Medical Center, Rotterdam, Netherlands. 14. Institute of Clinical Evaluative Sciences, University of Toronto, Ontario, Canada. 15. Department of Gastroenterology, Flinders Medical Centre, Adelaide, South Australia, Australia. 16. Department of Surgery and Molecular Oncology, University of Dundee, Dundee, UK. 17. Portland VA Medical Centre, Portland, Oregon, USA. 18. Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia.
Abstract
OBJECTIVE: Since the publication of the first Asia Pacific Consensus on Colorectal Cancer (CRC) in 2008, there are substantial advancements in the science and experience of implementing CRC screening. The Asia Pacific Working Group aimed to provide an updated set of consensus recommendations. DESIGN: Members from 14 Asian regions gathered to seek consensus using other national and international guidelines, and recent relevant literature published from 2008 to 2013. A modified Delphi process was adopted to develop the statements. RESULTS: Age range for CRC screening is defined as 50-75 years. Advancing age, male, family history of CRC, smoking and obesity are confirmed risk factors for CRC and advanced neoplasia. A risk-stratified scoring system is recommended for selecting high-risk patients for colonoscopy. Quantitative faecal immunochemical test (FIT) instead of guaiac-based faecal occult blood test (gFOBT) is preferred for average-risk subjects. Ancillary methods in colonoscopy, with the exception of chromoendoscopy, have not proven to be superior to high-definition white light endoscopy in identifying adenoma. Quality of colonoscopy should be upheld and quality assurance programme should be in place to audit every aspects of CRC screening. Serrated adenoma is recognised as a risk for interval cancer. There is no consensus on the recruitment of trained endoscopy nurses for CRC screening. CONCLUSIONS: Based on recent data on CRC screening, an updated list of recommendations on CRC screening is prepared. These consensus statements will further enhance the implementation of CRC screening in the Asia Pacific region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: Since the publication of the first Asia Pacific Consensus on Colorectal Cancer (CRC) in 2008, there are substantial advancements in the science and experience of implementing CRC screening. The Asia Pacific Working Group aimed to provide an updated set of consensus recommendations. DESIGN: Members from 14 Asian regions gathered to seek consensus using other national and international guidelines, and recent relevant literature published from 2008 to 2013. A modified Delphi process was adopted to develop the statements. RESULTS: Age range for CRC screening is defined as 50-75 years. Advancing age, male, family history of CRC, smoking and obesity are confirmed risk factors for CRC and advanced neoplasia. A risk-stratified scoring system is recommended for selecting high-risk patients for colonoscopy. Quantitative faecal immunochemical test (FIT) instead of guaiac-based faecal occult blood test (gFOBT) is preferred for average-risk subjects. Ancillary methods in colonoscopy, with the exception of chromoendoscopy, have not proven to be superior to high-definition white light endoscopy in identifying adenoma. Quality of colonoscopy should be upheld and quality assurance programme should be in place to audit every aspects of CRC screening. Serrated adenoma is recognised as a risk for interval cancer. There is no consensus on the recruitment of trained endoscopy nurses for CRC screening. CONCLUSIONS: Based on recent data on CRC screening, an updated list of recommendations on CRC screening is prepared. These consensus statements will further enhance the implementation of CRC screening in the Asia Pacific region. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: José Luis García-Giménez; Marta Seco-Cervera; Trygve O Tollefsbol; Carlos Romá-Mateo; Lorena Peiró-Chova; Pablo Lapunzina; Federico V Pallardó Journal: Crit Rev Clin Lab Sci Date: 2017-12-11 Impact factor: 6.250