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A dedicated high-quality service for the management of patients with an inherited risk of colorectal cancer.
- Source :
-
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2019 Aug; Vol. 21 (8), pp. 879-885. Date of Electronic Publication: 2019 Apr 08. - Publication Year :
- 2019
-
Abstract
- Aim: To demonstrate the quality improvement associated with the implementation of a specialist family history of bowel cancer service in secondary care.<br />Method: The following outcomes were assessed: (1) adherence to the British Society of Gastroenterology (BSG) guidelines for colonoscopic surveillance of individuals with a family history of colorectal cancer (CRC); (2) adherence to the revised Bethesda criteria for the identification of CRC patients with suspected Lynch syndrome; (3) identification of inherited syndromes with increased CRC risk; and (4) colonoscopic adenoma detection rate. Data were collected for a 21-month period before and after the establishment of this service for all patients who underwent colonoscopic surveillance for a family history of CRC and all patients newly diagnosed with CRC. Analyses compared the number of colonoscopies performed that were not indicated by BSG guidelines, the average number of years early that patients were screened, the adenoma detection rate and the rate of tumour testing for mismatch repair genes before and after the implementation of the service.<br />Results: Following the establishment of the service there was a reduction in the number of colonoscopies not indicated by BSG guidelines (39.6% before and 5.8% after, P < 0.001, chi-square test) and surveillance colonoscopy took place at a more appropriate age (10.6 years too early before and 5.9 years early after, P = 0.01, t-test). There was an increased adenoma detection rate (17% before and 31.9% after, P < 0.01, chi-square test) and increased tumour MMR testing (3.4% before and 91.8% after, P < 0.01, chi-square test).<br />Conclusion: The introduction of a family history of bowel cancer service results in improved patient care through improved adherence to guidelines for colonoscopic surveillance and increased cancer detection rates.<br /> (Colorectal Disease © 2019 The Association of Coloproctology of Great Britain and Ireland.)
- Subjects :
- Adenoma epidemiology
Adenoma genetics
Aged
Colonoscopy standards
Colorectal Neoplasms epidemiology
Colorectal Neoplasms genetics
Colorectal Neoplasms, Hereditary Nonpolyposis epidemiology
Colorectal Neoplasms, Hereditary Nonpolyposis genetics
Early Detection of Cancer methods
Female
Guideline Adherence
Health Plan Implementation
Humans
Male
Medical History Taking standards
Middle Aged
Program Evaluation
Quality Improvement
Secondary Care standards
United Kingdom epidemiology
Adenoma diagnosis
Colorectal Neoplasms diagnosis
Colorectal Neoplasms, Hereditary Nonpolyposis diagnosis
Early Detection of Cancer standards
Gastroenterology standards
Population Surveillance methods
Subjects
Details
- Language :
- English
- ISSN :
- 1463-1318
- Volume :
- 21
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
- Publication Type :
- Academic Journal
- Accession number :
- 30903731
- Full Text :
- https://doi.org/10.1111/codi.14622