Appropriateness of colonoscopy in Europe (EPAGE II). Screening for colorectal cancer
JournalItem (Reviews, Editorials, Rezensionen, Urteilsanmerkungen etc. in einer wissenschaftlichen Zeitschrift)
 
ID 1197526
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; EPAGE II Study Group
Author(s) at UniBasel Froehlich, Florian
Year 2009
Title Appropriateness of colonoscopy in Europe (EPAGE II). Screening for colorectal cancer
Journal Endoscopy
Volume 41
Number 3
Pages 200-8
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.
Publisher Georg Thieme
ISSN/ISBN 0013-726X
edoc-URL http://edoc.unibas.ch/dok/A6007681
Full Text on edoc No
Digital Object Identifier DOI 10.1055/s-0028-1119626
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/19280531
ISI-Number WOS:000264658400003
Document type (ISI) Journal Article, Review
 
   

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