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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Kongress Medizin und Gesellschaft 2007; 20070917-20070921; Augsburg; DOC07gmds636 /20070906/
    Publication Date: 2007-09-07
    Keywords: prostate cancer ; PSA ; fPSA ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
    Abstract: Guidelines recommend early colonoscopy for individuals with a positive family history of colorectal cancer (CRC), but little is known about the utilization of colonoscopy and the frequency of colorectal neoplasms among younger affected individuals in Germany. The aim of this study was to determine the utilization of colonoscopy and the frequency of colorectal neoplasms in this risk group. We conducted a cross-sectional study in a general practice setting. Patients aged 40-54 years with at least one first-degree relative with CRC were identified, counseled on their increased risk, and referred to colonoscopy if they decided to undergo this procedure. We assessed the reported utilization of colonoscopy before study participation with a questionnaire and obtained results of colonoscopies performed during the study period from colonoscopy reports. Out of 484 patients with a positive family history of CRC, 191 (39.5%) fulfilled the inclusion criteria and participated in the study: 54% reported that at least one colonoscopy had been performed before study participation. Out of 191 participants, 86 (45%) underwent a colonoscopy during study period. No CRC was found, but 16.3% had any adenoma, and 7.0% had advanced adenomas. Overall, 155 (82%) study participants underwent a colonoscopy either before or during the study period. The utilization of colonoscopies among participants was remarkably high even before study participation. This rate increased up to 82% after counseling by general practitioners. A relevant number of participants had (advanced) adenomas. It appears worthwhile to involve general practitioners in identifying and counseling younger individuals with familial risk for CRC.
    Type of Publication: Journal article epub ahead of print
    PubMed ID: 28692588
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  HEC 2016: Health - Exploring Complexity; Joint Conference of GMDS, DGEpi, IEA-EEF, EFMI; 20160828-20160902; München; DOCAbstr. 089 /20160808/
    Publication Date: 2016-08-11
    Keywords: Pharmacoepidemiology ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi); 20110926-20110929; Mainz; DOC11gmds008 /20110920/
    Publication Date: 2011-09-20
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
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  • 5
    Keywords: CANCER ; Germany ; DIAGNOSIS ; screening ; POPULATION ; PATIENT ; MARKER ; colon ; tumour ; early detection ; AGE ; colorectal cancer ; FECAL-OCCULT-BLOOD ; COLORECTAL-CANCER ; LONG-TERM SURVIVAL ; CANCER-PATIENTS ; specificity ; CANCER PATIENTS ; ONCOLOGY ; ADULTS ; RE ; INTERVAL ; analysis ; TESTS ; rectum ; colorectal ; - ; M2 PYRUVATE-KINASE ; PERFORMANCE-CHARACTERISTICS ; stool test ; tumour M2-PK
    Abstract: Stool testing based on tumour-derived markers might offer a promising approach for non-invasive colorectal cancer (CRC) screening. The aim of this study was to estimate the potential of a new test for faecal tumour M2-PK to discriminate patients with CRC from a large sample of unselected older adults. Faecal tumour M2-PK concentrations were determined in 65 CRC patients and in a population-based sample of 917 older adults (median age: 65 and 62 years, respectively). Sensitivity and specificity of the test were calculated at different cutoff values, and receiver-operating characteristic curves (ROC) were constructed to visualise the discriminatory power of the test. The median ( interquartile range) faecal tumour M2-PK concentration was 8.6 U ml(-1) (2.8-18.0) among CRC patients and 〈 2 U ml(-1) (〈 2-3.2; P 〈 0.0001) in the population sample. At a cutoff value of 4 U ml(-1), sensitivity (95% confidence interval) was 85% ( 65 - 96%) for colon cancer and 56% (41-74%) for rectum cancer. Specificity (95% confidence interval) was estimated to be 79% (76-81%). Given the comparatively high sensitivity of the tumour M2-PK stool test (especially for colon cancer) and its simple analysis, the potential use of the test for early detection of CRC merits further investigation. Possibilities to enhance specificity of the test should be explored
    Type of Publication: Journal article published
    PubMed ID: 17406361
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  • 6
    Keywords: CANCER ; Germany ; screening ; EPIDEMIOLOGY ; incidence ; MORTALITY ; prevention ; AGE ; WOMEN ; colorectal cancer ; MEN ; COLORECTAL-CANCER ; COUNTRIES ; GUIDELINES ; ONCOLOGY ; RE ; aging ; LEVEL ; ENGLAND
    Abstract: We assessed incidence and mortality of colorectal cancer (CRC) at various ages among women and men in 38 European countries. The ages at which defined levels of incidence and mortality were reached varied between 9 and 17 years between countries. This variation requires consideration in the definition of screening guidelines
    Type of Publication: Journal article published
    PubMed ID: 18628760
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  • 7
    Keywords: CANCER ; evaluation ; Germany ; PROSTATE ; cohort studies ; NEW-YORK ; POPULATION ; RISK ; SAMPLE ; MARKER ; ANTIGEN ; CONTRAST ; early detection ; AGE ; prostate cancer ; PROSTATE-CANCER ; INITIATION ; URINE ; inflammation ; SERUM ; RE ; aging ; AUTOPSY ; methods ; TESTS ; USA ; S100A8 ; population-based ; prostatic neoplasms ; biological ; TUMOR MARKERS ; Calgranulin B ; early diagnosis
    Abstract: Purpose: Early detection of prostate cancer by prostate specific antigen testing is subject to ongoing controversy. Thus, practical tests to improve or replace prostate specific antigen would be highly desirable. In diagnostic studies promising results were shown for myeloid related protein-14 in serum and urine. However, confirmation in longitudinal population based studies is needed. Materials and Methods: Incident prostate cancer cases (32) and controls (74) matched by age were identified during a 2-year followup of a longitudinal study. The group of cases was further complemented by a sample of 24 prostate cancer cases recruited before initiation of treatment from a clinical study. A commercially available test was used to analyze serum and urinary myeloid related protein-14 in blinded fashion. Results: In contrast to prostate specific antigen, serum and urinary myeloid related protein-14 could not significantly discriminate between prostate cancer cases and controls. Conclusions: In our study, neither serum nor urinary myeloid related protein-14 proved suitable to distinguish prostate cancer cases from controls. Overall myeloid related protein-14 performed much worse than prostate specific antigen and it does not seem useful to reduce false-positive findings of prostate specific antigen in the controversial range of 4 to 10 ng/ml
    Type of Publication: Journal article published
    PubMed ID: 18707695
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  • 8
    Keywords: CANCER ; colonoscopy ; POLYPS ; TASK-FORCE
    Abstract: OBJECTIVES:Quantitative and qualitative immunochemical fecal occult blood tests (FOBTs) have been proposed for noninvasive colorectal cancer screening, but comparative evaluation is lacking. The aim of this study was to determine the diagnostic accuracy of two (quantitative) enzyme-linked immunosorbent assay (ELISA)-based immunochemical FOBTs for identifying colorectal adenomas in the target population of screening and to compare the results with six (qualitative) immunochromatographic FOBTs, previously evaluated in the same study participants using the same stool samples.METHODS:A total of 1,319 participants of screening colonoscopy at average risk for colorectal neoplasia (mean age 63 years; age range 31-86 years; 50% men) were recruited prospectively from January 2006 to December 2007 in collaboration with 20 gastroenterological practices in Germany. Fecal hemoglobin and hemoglobin-haptoglobin levels were measured using an automated ELISA (RIDASCREEN). Test performance characteristics at different cutoff values were derived by comparing the results of stool testing with the results of colonoscopy in a blinded manner.RESULTS:A total of 130 participants (10%) had an advanced adenoma. The area under the receiver-operating characteristic curve with regard to advanced adenomas was 0.68 (0.65-0.71) for hemoglobin and 0.64 (0.61-0.67) for hemoglobin-haptoglobin (P=0.034). At a specificity of approximately 95%, the sensitivity (95% confidence interval) for advanced adenomas was 33% (25-42%) for hemoglobin and 24% (17-32%) for hemoglobin-haptoglobin, respectively. The sensitivity for hemoglobin was very close to sensitivities of the six qualitative FOBTs at (strongly divergent) levels of specificity observed for the latter.CONCLUSIONS:ELISA-based measurement of hemoglobin was superior to hemoglobin-haptoglobin, but showed a similar sensitivity for advanced adenomas compared with (qualitative) immunochromatographic FOBTs at defined levels of specificity. Compared with the latter, its quantitative nature offers advantages in terms of transparency and flexibility regarding the positivity threshold (e.g., specificity can be oriented toward available colonoscopy resources or personal risk profiles) and in terms of a higher level of standardization regarding test analysis and interpretation.
    Type of Publication: Journal article published
    PubMed ID: 19953091
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  • 9
    Keywords: CANCER ; POPULATION ; RISK ; prevention ; NONSTEROIDAL ANTIINFLAMMATORY DRUGS ; CARDIOVASCULAR-DISEASE ; TASK-FORCE ; AMERICAN-COLLEGE ; OUTPATIENT COLONOSCOPY ; COLORECTAL ADENOMA DETECTION
    Abstract: CONTEXT: Immunochemical fecal occult blood tests (iFOBTs) are potentially promising tools for colorectal cancer screening. Low-dose aspirin use, which increases the likelihood of gastrointestinal bleeding, is common in the target population for colorectal cancer screening. OBJECTIVE: To assess the association of low-dose aspirin use with the performance of 2 quantitative iFOBTs in a large sample of patients undergoing colorectal cancer screening. DESIGN, SETTING, AND PARTICIPANTS: Diagnostic study conducted from 2005 through 2009 at internal medicine and gastroenterology practices in southern Germany including 1979 patients (mean age, 62.1 years): 233 regular users of low-dose aspirin (167 men, 67 women) and 1746 who never used low-dose aspirin (809 men, 937 women). MAIN OUTCOME MEASURES: Sensitivity, specificity, positive and negative predictive values, and area under receiver operating characteristic (ROC) curves in detecting advanced colorectal neoplasms (colorectal cancer or advanced adenoma) with 2 quantitative iFOBTs. RESULTS: Advanced neoplasms were found in 24 users (10.3%) and 181 nonusers (10.4%) of low-dose aspirin. At the cut point recommended by the manufacturer, sensitivities of the 2 tests were 70.8% (95% confidence interval [CI], 48.9%-87.4%) for users compared with 35.9% (95% CI, 28.9%-43.4%) for nonusers and 58.3% (95% CI, 36.6%-77.9%) for users compared with 32.0% (95% CI, 25.3%-39.4%) for nonusers (P = .001 and P = .01, respectively). Specificities were 85.7% (95% CI, 80.2%-90.1%) for users compared with 89.2% (95% CI, 87.6%-90.7%) for nonusers and 85.7% (95% CI, 80.2%-90.1%) for users compared with 91.1% (95% CI, 89.5%-92.4%) for nonusers (P = .13 and P = .01, respectively). The areas under the ROC curve were 0.79 (95% CI, 0.68-0.90) for users compared with 0.67 (95% CI, 0.62-0.71) for nonusers and 0.73 (95% CI, 0.62-0.85) for users compared with 0.65 (95% CI, 0.61-0.69) for nonusers (P = .05 and P = .17, respectively). Among men, who composed the majority of low-dose aspirin users, the areas under the ROC curve were 0.87 (95% CI, 0.76-0.98) for users compared with 0.68 (95% CI, 0.63-0.74) for nonusers and 0.81 (95% CI, 0.68-0.93) for users compared with 0.67 (95% CI, 0.61-0.72) for nonusers (P = .003 and P = .04, respectively). CONCLUSION: For 2 iFOBTs, use of low-dose aspirin compared with no aspirin was associated with a markedly higher sensitivity for detecting advanced colorectal neoplasms, with only a slightly lower specificity.
    Type of Publication: Journal article published
    PubMed ID: 21139112
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  • 10
    Keywords: APOPTOSIS ; CELLS ; RISK ; ASSOCIATION ; polymorphism ; cancer prevention ; COLON-CANCER ; DIETARY ; CALCIUM ; SUNLIGHT ; SERUM ; METAANALYSIS ; colorectal adenoma ; 25-HYDROXYVITAMIN-D ; D-RECEPTOR ; Meta analysis ; Serum vitamin D
    Abstract: OBJECTIVE: To perform a systematic review and meta-analysis of human studies on the association between serum 25 hydroxyvitamin D (25(OH)D) and incident, sporadic colorectal adenoma (CRA) and CRA recurrence. METHODS: Relevant studies among humans were identified by systematically searching Ovid Medline, EMBASE, and ISI Web of Knowledge databases and by cross-referencing. Due to the heterogeneity across studies in categorizing serum vitamin D levels, all results were recalculated for an increase of serum 25(OH)D by 20ng/ml. Summary odds ratios (ORs) were calculated using meta-analysis methods. RESULTS: Overall, 10 original studies were included. Specific results for incident CRA according to serum 25(OH)D were reported in 8 studies, and for CRA recurrence in 2 studies, respectively. In meta-analyses, summary ORs (95% confidence intervals) regarding incident and recurrent CRA, and both outcomes combined were 0.82 (0.69-0.97), 0.87 (0.56-1.35), and 0.84 (0.72-0.97), respectively, for an increase of 25(OH)D by 20ng/ml. No publication bias was found. CONCLUSION: Our results support suggestions that serum 25(OH)D levels are inversely associated with CRA risk.
    Type of Publication: Journal article published
    PubMed ID: 21672549
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