Appropriateness of colonoscopy in Europe (EPAGE II). Screening for colorectal cancer.

Details

Serval ID
serval:BIB_F6BF736F407F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Appropriateness of colonoscopy in Europe (EPAGE II). Screening for colorectal cancer.
Journal
Endoscopy
Author(s)
Arditi C., Peytremann-Bridevaux I., Burnand B., Eckardt V.F., Bytzer P., Agréus L., Dubois R.W., Vader J.P., Froehlich F., Pittet V., Schusselé Filliettaz S., Juillerat P., Gonvers J.J.
Working group(s)
EPAGE II Study Group
Contributor(s)
Agréus L., Beglinger C., Bytzer P., Delvaux M., Eckardt VF., Fairclough PD., Lacaine F., Le Moine O., Lorenzo-Zúñiga V., Minoli G., Numans ME., Oertli D., O'Malley J., Windsor A.
ISSN
1438-8812 (Electronic)
ISSN-L
0013-726X
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
41
Number
3
Pages
200-208
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Abstract
BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for screening for colorectal cancer (CRC) in asymptomatic individuals without personal history of CRC or polyps, and report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II.
METHODS: A systematic search of guidelines, systematic reviews, and primary studies regarding colonoscopy for screening for colorectal cancer was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy in these circumstances.
RESULTS: Available evidence for CRC screening comes from small case-controlled studies, with heterogeneous results, and from indirect evidence from randomized controlled trials (RCTs) on fecal occult blood test (FOBT) screening and studies on flexible sigmoidoscopy screening. Most guidelines recommend screening colonoscopy every 10 years starting at age 50 in average-risk individuals. In individuals with a higher risk of CRC due to family history, there is a consensus that it is appropriate to offer screening colonoscopy at < 50 years. EPAGE II considered screening colonoscopy appropriate above 50 years in average-risk individuals. Panelists deemed screening colonoscopy appropriate for younger patients, with shorter surveillance intervals, where family or personal risk of colorectal cancer is higher. A positive FOBT or the discovery of adenomas at sigmoidoscopy are considered appropriate indications.
CONCLUSIONS: Despite the lack of evidence based on randomized controlled trials (RCTs), colonoscopy is recommended by most published guidelines and EPAGE II criteria available online (http://www.epage.ch), as a screening option for CRC in individuals at average risk of CRC, and undisputedly as the main screening tool for CRC in individuals at moderate and high risk of CRC.
Keywords
Colonoscopy, Colorectal Neoplasms/pathology, Europe, Guidelines as Topic, Humans, Randomized Controlled Trials as Topic
Pubmed
Web of science
Open Access
Yes
Create date
04/08/2009 10:00
Last modification date
20/08/2019 17:23
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