Background/aims: For colorectal screening patients a gain of life time was previously calculated to be about 30-50 days. Different recommendations for recognizing at-risk groups and defining surveillance intervals after an initial finding of colorectal adenomas have been published. However, no benefit-risk analysis regarding specific long-term effects of follow-up patients has been reported to date.
Methodology: A Markov model based on time-dependent transition possibilities was developed to compare two surveillance schedules: recommendations based on the Erlangen Registry of Colorectal Polyps (ERCRP) and the National Polyp Study (NPS). The outcome was calculated for a 50-year-old patient with 30 years of follow-up after initial polypectomy. The data used in this model were taken from different sources, namely the ERCRP, the German Study Group of Colorectal Cancer, the German Statistical Yearbook, and from meta-analyses of studies reporting data on complications and sensitivity of colonoscopy.
Results: Patients under surveillance have a mean lifetime gain of 98 (ERCRP) and 91 (NPS) days compared with those who do not come for surveillance. Approximately 84% and 79% of deaths from colorectal carcinoma (CRC) could be prevented if patients were followed up according to the recommendations of the ERCRP and the NPS, respectively. The risk of death due to colonoscopy for patients during followup is about 0.05% lifetime risk. Sensitivity analysis showed the stability of the results under a wide range of reasonable variations of relevant parameters. In a pessimistic one-way sensitivity analysis regarding compliance, effectiveness was reduced to one third.
Conclusions: Surveillance using colonoscopy is an effective tool for preventing CRC after colorectal polypectomy and similar to the screening procedure. The effectiveness is slightly higher when following the recommendations of the ERCRP, especially if a more realistic compliance is assumed.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Analysis of Delirium Risk Assessment Tools for Prediction of Postoperative Delirium Following Lumbar Spinal Fusion.
Spine (Phila Pa 1976)
January 2025
Department of Orthopedics, Brown University, Providence, RI.
Study Design: Retrospective cohort study.
Objective: Evaluate the utility of Delirium Risk Assessment Score (DRAS), Delirium Risk Assessment Tool (DRAT), and Delirium Elderly At-Risk (DEAR) in patients undergoing posterior lumbar interbody fusions.
Background: Surgical interventions can place patients at risk for postoperative delirium (POD), an acute and often severe cognitive impairment associated with poor outcomes.
Sudden cardiac death after acute myocarditis with arrhythmic presentation: hunting for risk predictors - a systematic review and meta-analysis.
Open Heart
November 2024
Cardiothoracic Department, Santa Maria della Misericordia University Hospital, Udine, Italy
Background: Ventricular arrhythmias (VAs) frequently occur in the acute phase of myocarditis. Possible arrhythmic recurrences and the risk of sudden cardiac death (SCD) in this setting are reasons for concern, and limited data have been published to guide clinical management of these patients. The aim of the present paper is to report the incidence of major arrhythmic events, defined as sustained VA, SCD and appropriate implantable cardiac-defibrillator (ICD) treatment, in patients with acute myocarditis and ventricular arrhythmic phenotype.
View Article and Find Full Text PDFArsenic, manganese, and iron concentration in groundwater of northwestern part of Bangladesh using self-organizing maps: Implication for health risk assessment.
Heliyon
January 2025
Department of Geology and Mining, University of Rajshahi, Rajshahi, 6205, Bangladesh.
Quantification of the non-linear relationship between arsenic (As) and physico-chemical parameters in groundwater through a Self-Organizing Map (SOM) was performed for the first time in Chapai-Nawabganj, Bangladesh. Due to the continuous assessment of groundwater quality, the spatial distribution of As with associated elements was observed for the aerial extent of contaminated groundwater. The results exhibited that 57 % and 31 % of groundwater samples (n = 35) exceeded the allowable limit of As according to the WHO recommended drinking water standard (10 μg/L) and Bangladesh Drinking Water Standard (BDWS) (50 μg/L), respectively.
View Article and Find Full Text PDFWintertime black carbon assessment in dhaka, Bangladesh: Integrated health risk analysis.
Heliyon
January 2025
Department of Chemistry, Faculty of Science, University of Dhaka, Dhaka, 1000, Bangladesh.
This study investigated the ramifications of black carbon (BC) emissions on human health during the winter season of December 2019 to February 2020 in Dhaka, Bangladesh. BC, arising from incomplete combustion of fossil and biofuels, underwent meticulous measurement of densities, concentrations, and emissions at two pivotal sites. Employing low-volume air samplers with Quartz filters and subsequent analysis with an Aethalometer (Soot scanner, OT21, USA), the study unveiled monthly average BC densities of 1.
View Article and Find Full Text PDFTracking changes in autonomic function by coupled analysis of wavelet-based dispersion of heart rate variability and gastrointestinal symptom severity in individuals with hypermobile Ehlers-Danlos syndrome.
Front Neurol
January 2025
ARID Laboratory, Department of Pediatrics, College of Medicine, University of Arizona, Tucson, AZ, United States.
Introduction: People with hypermobile Ehlers-Danlos syndrome (hEDS) experience multisystemic dysfunction with varying severity and unpredictability of flare occurrence. Cohort studies suggest that individuals with hEDS have a higher risk for autonomic dysfunction. The gold standard for assessing autonomic function, clinically, is the heart rate variability (HRV) assessment from 24-h Holter monitor electrocardiogram data, but this is expensive and can only be performed in short durations.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!