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Colorectal cancer screening guidelines in primary care

Colorectal cancer screening guidelines in primary care. By Dr Nahla Madan NCD Committee April 2010. The working group on the guideline. The working Group. Reviewing Group. Dr. Ibtihal Al Reefy Dr. Badryia Yaser Dr. Fathyia Abdulla Dr. Mai Bubshait Dr. Basma Al Tajer.

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Colorectal cancer screening guidelines in primary care

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  1. Colorectal cancer screening guidelines in primary care By Dr Nahla Madan NCD Committee April 2010

  2. The working group on the guideline The working Group Reviewing Group • Dr. Ibtihal Al Reefy • Dr. BadryiaYaser • Dr. Fathyia Abdulla • Dr. Mai Bubshait • Dr. Basma Al Tajer • Dr. A. Hussain AL Ajami • Dr. Mariam Al-Jalahma • Dr. Kadhim Jaffer Zaber • Dr. Ali Mirza Salman • Dr. Abeer Al Ghawi

  3. Colorectal cancerfacts • Majority of colorectal cancer develop from precancerous changes (polyps) • About 90% of patients are over the age of 50 • Early Colorectal cancers are usually asymptomatic • The average duration of symptoms (from onset to diagnosis) is 14 weeks. There is no association between overall duration of symptoms and the stage of the tumor

  4. Symptoms of Colorectal Cancer :May Includes • Constipation/Diarrhea • Narrow Stools • Abdominal Cramps • Bloody Stools • Unexplained Weight Loss/Loss of Appetite • Sense of Fullness • Nausea & Vomiting • Gas & Bloating • Lethargy (Fatigue)

  5. Colorectal cancer Risk factors • Age >50 • Personal or family history of colorectal cancer or adenomatous polyp • Familial syndromes as Familial Adenomatous Polyposis (FAP) or Hereditary Non-polyposis Colorectal Cancer (HNPCC) • H/o inflammatory bowel diseases • High animal fat diet • Tobacco • Physical inactivity

  6. Colorectal screening guidelines in PHC For average risk population • Screening starts at the age of 50-90 or until there is a 30% chance of living to the next screening interval

  7. Colorectal screening guidelines in PHC For average risk population Fecal Occult Blood Test (FOBT) annually and Flexible Sigmoidoscopy every 5 years or Colonoscopy every 10 years

  8. Colorectal screening guidelines in PHC For High risk population • Screening start at the age of 40 or 10 years before the age of cancer in the first degree relative • First degree relative: Any relative who is one meiosis away from a particular individual in a family (i.e., parent, sibling, offspring)

  9. Colorectal screening guidelines in PHC For special risk population • Patients with hereditary colorectal cancer syndrome should undergo annual colonoscopy • Patients with Ulcerative Colitis or Crohn’s Colitis of 7-10 years duration should start colonoscopy screening every 1-3 years

  10. Colorectal Screening tests • Colonoscopy is the most sensitive and specific test of the all available screening tests of colorectal cancer • FOBT has the most direct evidence of reducing colorectal cancer mortality • The sensitivity of sigmoidoscopy as a screening tests affected by type of the instrument

  11. What is available in PHC • A pilot screening campaign will be started using HEXAGON OBTI to test stool for human blood in all adult 50-90 years of age attending LHC • The available test sample for the pilot campaign is 500, and will be distributed in the following HC: • Muharraq HC • Shaikh Sabah HC • A’ali HC • East Raffa HC

  12. Pilot screening campaign for colorectal cancer • The pilot period will end by using all the test samples • It is necessary to collect data about the tested candidates for the future analysis and updating of the guidelines • Collecting data will be by a form filled by the referring physician • After the pilot campaign, guidelines of colorectal cancer screening will be updating and a second awareness session will follow

  13. HEXAGON OBTI Immunochromatographic rapid test This rapid screening test detects human blood in the stool. HEXAGON OBTI is a two-part test: - Collection tube for the blood sample - Test bar

  14. Directions Unscrew the cap of the tube and collect the sample with the applicator stick by taking several postions at different sites (3-4) of the faeces . Remove excess stool with a tissue. Reinsert the applicator stick into the tube. This sample collected is stable at room temperature and must be tested within one week after collection. With the lid screwed back on, shake the sample gently inside the transport medium to assure proper mixing.

  15. Directions Hold the tube with the red end upwards and break-off the tip. Dispense exactly 2 full drops, drop by drop, into the test in the sample well (S) at the lower end of the test.

  16. Results A positive sample is typically detected within 2-3 minutes. Negative results should be confirmed after 10 minutes.

  17. Interpretation of Results • A single blue line means the testing liquid is working fine, but no human blood has been detected. It is called a “control line“ • Two blue lines mean the test has detected human blood (even if blue color is weak) • No control line means that the test should be repeated

  18. Negative Positive Invalid

  19. Other features • The test kit is stable up to the given expiration date when stored at 2 – 25 oC • Dietary restrictions are not necessary

  20. Thank You and hope you a good day

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