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Patient Navigators Improve Colonoscopy Rates After Abnormal Stool Tests, Study Shows

Timely follow-up colonoscopies can reduce the mortality rate from colorectal cancer, and patient navigators can play an important role in facilitating screening.

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Patient navigators have been shown to increase the likelihood of patients receiving follow-up colonoscopies after abnormal stool tests, according to a recent study published in the Annals of Internal Medicine. The research, led by the University of Arizona Health Sciences, found that 55% of patients assigned to patient navigators received follow-up colonoscopies within a year, compared to 42.5% of those who received usual care without a navigator.

The study, titled “Predicting and Addressing Coloscopy Non-Adherence in Community Settings” (PRECISE), enrolled over 970 patients aged 50-75 with abnormal fecal immunochemical test (FIT) results. Half of the participants were randomly assigned to receive patient navigation, while the other half received standard care consisting of up to two phone calls and a letter to schedule a colonoscopy appointment.

Patient navigators played a crucial role in ensuring that patients understood the importance of getting a colonoscopy after an abnormal stool test result. They sent introductory letters, made phone calls, and delivered text messages addressing six topic areas at scheduled times: introduction and barrier assessment, barrier resolution, bowel preparation instructions, bowel preparation reminder, colonoscopy check-in, and a final checkup following the completed procedure.

The results of the study were striking: patients who received patient navigation had a 12% higher completion rate for follow-up colonoscopies within one year compared to those who did not receive navigation. Furthermore, patients allocated to navigation obtained a colonoscopy an average of 27 days sooner than usual care patients.

According to the American Cancer Society, colorectal cancer is the third-leading cause of cancer-related deaths in U.S. men and the fourth-leading cause in U.S. women. However, it’s the second most common cause of cancer deaths when numbers for men and women are combined.

The study’s lead author, Dr. Gloria Coronado, emphasized the importance of early detection and treatment of colorectal cancer. She noted that patients who delay receiving follow-up colonoscopies after abnormal stool test results are seven times more likely to die from colorectal cancer.

In conclusion, the PRECISE study demonstrates the effectiveness of patient navigators in increasing the likelihood of patients receiving follow-up colonoscopies after abnormal stool tests. As Dr. Coronado pointed out, standardizing navigation procedures can help clinics notify patients of their results and assist them in understanding the importance of a colonoscopy. This approach has the potential to substantially reduce the colorectal cancer mortality rate and improve patient survival rates through earlier cancer detection.

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Early-Onset Cancers on the Rise: A Growing Concern for Public Health

Researchers have completed a comprehensive analysis of cancer statistics for different age groups in the United States and found that from 2010 through 2019, the incidence of 14 cancer types increased among people under age 50.

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The National Institutes of Health (NIH) has conducted a comprehensive analysis of cancer statistics for different age groups in the United States. The study reveals that between 2010 and 2019, the incidence rates of 14 cancer types increased among people under the age of 50. These cancer types include breast cancer, colorectal cancer, kidney cancer, uterine cancer, and others.

Lead investigator Meredith Shiels, Ph.D., notes that this study provides a starting point for understanding which cancers are increasing among individuals under 50. The causes of these increases are likely to be specific to each type of cancer, including changes in cancer risk factors, screening or detection methods, and clinical diagnosis or coding.

The researchers analyzed incidence and mortality trends for 33 cancer types using data from the Centers for Disease Control and Prevention’s United States Cancer Statistics database and national death certificate data. They examined six age groups: three early-onset (15-29 years, 20-39 years, and 40-49 years) and three older-onset (50-59 years, 60-69 years, and 70-79 years).

The study found that the incidence of nine cancer types increased in at least one of the younger age groups, including female breast, colorectal, kidney, testicular, uterine, pancreatic, and three types of lymphoma. Although death rates did not increase in early-onset age groups for most of these cancers, researchers observed concerning increases in rates of colorectal and uterine cancer deaths at younger ages.

Only five cancer types increased in incidence among one of the younger age groups but not among any of the older age groups: melanoma, cervical cancer, stomach cancer, myeloma, and cancers of the bones and joints.

To better understand the magnitude of these increases, researchers estimated how many additional people were diagnosed with early-onset cancers in 2019 compared to expected diagnoses based on rates in 2010. The largest absolute increases were seen for female breast cancer (4,800 additional cases), followed by colorectal (2,100), kidney (1,800), uterine (1,200), and pancreatic cancers (500).

The researchers speculate that risk factors such as increasing obesity may have contributed to some of the increases in early-onset cancer incidence. Changes in cancer screening guidelines, advances in imaging technologies, and increased surveillance of high-risk individuals may also have led to earlier cancer diagnoses, potentially contributing to rising rates among younger age groups.

To more fully understand and address these increasing rates, future studies should examine trends in early-onset cancers across demographics and geography in the U.S. and internationally. Additional research is also needed to better understand the risk factors that are particularly relevant to younger people.

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Early Cancer Detection: New Algorithms Revolutionize Primary Care

Two new advanced predictive algorithms use information about a person’s health conditions and simple blood tests to accurately predict a patient’s chances of having a currently undiagnosed cancer, including hard to diagnose liver and oral cancers. The new models could revolutionize how cancer is detected in primary care, and make it easier for patients to get treatment at much earlier stages.

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Early Cancer Detection: New Algorithms Revolutionize Primary Care

Two groundbreaking predictive algorithms have been developed to help General Practitioners (GPs) identify patients who may have undiagnosed cancer, including hard-to-detect liver and oral cancers. These advanced models use information about a patient’s health conditions and simple blood tests to accurately predict their chances of having an undiagnosed cancer.

The National Health Service (NHS) currently uses algorithms like the QCancer scores to combine relevant patient data and identify individuals at high risk of having undiagnosed cancer, allowing GPs and specialists to call them in for further testing. Researchers from Queen Mary University of London and the University of Oxford have created two new algorithms using anonymized electronic health records from over 7.4 million adults in England.

The new models are significantly more sensitive than existing ones, potentially leading to better clinical decision-making and earlier cancer diagnosis. Crucially, these algorithms incorporate the results of seven routine blood tests as biomarkers to improve early cancer detection. This approach makes it easier for patients to receive treatment at much earlier stages, increasing their chances of survival.

Compared to the QCancer algorithms, the new models identified four additional medical conditions associated with an increased risk of 15 different cancers, including liver, kidney, and pancreatic cancers. The researchers also found two additional associations between family history and lung cancer and blood cancer, as well as seven new symptoms of concern (itching, bruising, back pain, hoarseness, flatulence, abdominal mass, dark urine) associated with multiple cancer types.

The study’s lead author, Professor Julia Hippisley-Cox, said: “These algorithms are designed to be embedded into clinical systems and used during routine GP consultations. They offer a substantial improvement over current models, with higher accuracy in identifying cancers – especially at early, more treatable stages.”

Dr Carol Coupland, senior researcher and co-author, added: “These new algorithms for assessing individuals’ risks of having currently undiagnosed cancer show improved capability of identifying people most at risk of having one of 15 types of cancer based on their symptoms, blood test results, lifestyle factors, and other information recorded in their medical records.”

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Tailoring Bowel Cancer Surveillance for a Changing Healthcare Landscape

Australia’s recent move to lower the starting age for bowel (colorectal) cancer screening from 50 down to 45 years old will mean better outcomes — but it will also increase the burden on an already struggling healthcare system, warn researchers. They predict that the expanded screening program will likely lead to an influx of younger adults who will require ongoing surveillance with regular colonoscopies, prompting the team to review current clinical guidelines for at risk individuals.

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In a bid to improve bowel cancer outcomes, Australia has lowered its starting age for screening from 50 to 45 years old. While this move is expected to lead to better results, it will also put additional pressure on an already strained healthcare system.

Flinders University researchers have sounded the alarm, warning that the expanded screening program could lead to a surge in younger adults requiring ongoing surveillance with regular colonoscopies. In response, the team has reviewed current clinical guidelines for at-risk individuals and explored alternative approaches to better meet their needs.

A new study led by Flinders University reveals a shift in how bowel cancer surveillance might be approached using faecal tests. This approach could provide extra peace of mind for those at risk, particularly younger adults who are more concerned about bowel cancer despite it being traditionally viewed as an “older person’s disease”.

The researchers surveyed almost 300 people at risk for bowel cancer and found that most participants, regardless of age, wanted more frequent bowel cancer surveillance than what is currently recommended. A significant percentage preferred more frequent colonoscopies, with many supporting the incorporation of faecal tests between surveillance colonoscopies.

The study highlighted the role of fear in influencing surveillance preferences, with younger adults reporting higher levels of fear regarding bowel cancer and a preference for more frequent monitoring. This suggests that healthcare providers might want to consider this psychological aspect when providing care for younger adults at risk.

The researchers proposed adding faecal tests into existing colonoscopy-based surveillance protocols to allow for personalized strategies that extend the time between colonoscopies for those with negative results. Such an approach could meet the needs of patients wanting closer monitoring while also optimizing resource use in healthcare systems.

As early-onset bowel cancer continues to rise, this study reinforces the urgent need to adapt and update surveillance strategies to suit younger adults. Traditional guidelines often do not address the specific concerns and preferences of this demographic, which is becoming increasingly significant as screening eligibility ages are lowered.

By tailoring bowel cancer surveillance to individual needs, healthcare providers can improve patient outcomes while also optimizing resource use in a changing healthcare landscape.

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