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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Clinical outcomes from the CDC's Colorectal Cancer Screening Demonstration Program
Laura C Seeff1, Janet Royalty, William E Helsel
1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA. lseeff@cdc.gov
Cancer
|July 23, 2013
Summary
The Colorectal Cancer Screening Demonstration Program (CRCSDP) successfully screened over 5,000 individuals, identifying cancers and precancerous polyps. This initiative highlighted effective screening strategies for underserved populations.
Area of Science:
- Public Health
- Preventive Medicine
- Gastroenterology
Background:
- Colorectal cancer is a leading cause of cancer deaths in the US.
- Screening rates for colorectal cancer remain suboptimal, with persistent disparities.
- Targeted programs are needed to address these screening gaps.
Purpose of the Study:
- To describe the design and clinical outcomes of the Colorectal Cancer Screening Demonstration Program (CRCSDP).
- To evaluate screening test performance, including fecal occult blood testing (FOBT) and colonoscopy.
- To assess polyp, adenoma, and cancer detection rates in an under-served population.
Main Methods:
- The Centers for Disease Control and Prevention (CDC) implemented a 4-year CRCSDP for low-income, uninsured/under-insured individuals aged 50-64.
- The program involved 5 US sites and screened 5233 participants using FOBT or colonoscopy.
- Data collected included FOBT positivity rates, detection rates for polyps, adenomas, and cancers, and positive predictive values.
Main Results:
- Overall, 5233 individuals were screened; 44% used FOBT and 56% used colonoscopy.
- The FOBT positivity rate was 10%.
- Colonoscopies revealed 75% negative results, 16% low-risk adenomas, 8% high-risk adenomas, and 0.6% invasive cancers.
Conclusions:
- The CRCSDP demonstrated successes and challenges in implementing a large-scale colorectal cancer screening program.
- Clinical outcomes and test performance characteristics of FOBT and colonoscopy were evaluated.
- Patterns in screening uptake and outcomes aligned with national data, suggesting program effectiveness.
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