A screening colonoscopy is done for the significance of colorectal cancer prevention. Colonoscopy allows visualization of the entire mucosa of the distal terminal ileum and the large intestine. A long flexible tube called a colonoscope is inserted in the rectum during the examination. A tiny camera in the tip allows the doctor to detect changes or abnormalities in the entire colon. The procedure takes about 30 to 60 minutes, and the screening is generally repeated after ten years if no abnormalities are detected (Kastenberg et al., 2018). Principles of screening are essential in analyzing the effectiveness of a screening tool.
The first principles of screening entail the condition sort and its importance to public health. Colorectal cancer (CRC) is a significant cause of mortality and mobility worldwide. CRC has become a global public health issue. International Agency for Research on Cancer (IARC) estimates that there are 1.8 million new cases of CRC and 881,000 deaths worldwide (Gunter et al., 2019). The importance of this illness to gastroenterologists cannot be understated, given that surveillance and screening colonoscopy are dominant segments of clinical practice. Treatment for CRC is available, which involves surgical removal of cancer. Other treatment options include chemotherapy and radiation therapy. If the colon cancer is very small, the doctor may recommend minimally invasive approaches such as polypectomy and Endoscopic mucosal resection.
Colonoscopy is regarded to be among the best practical screening exam for CRC. The sensitivity to detect adenomas 6mm or larger ranges from 75% to 93% (Wolf et al., 2018). The specificity range is great, ranging from 99.6% to 100% (Wolf et al., 2018). Colonoscopy has been considered the standard gold test for detecting neoplasia and precancerous lesions and removing polyps. The tool has shown an 89% reduction in colon cancer incidents and a 90% survival rate when the cancer is detected at early stages (Wolf et al., 2018). For colonoscopy, the positive predictive value for detecting lesions of at least 6 mm and at least 10 mm is 100 percent, and the negative predictive is 99.8 percent (Wolf et al., 2018). The levels indicate excellent sensitivity, specificity, and predictive levels of colonoscopy.
The natural history of colorectal cancer is known concerning the third screening principle. Before the screening, the natural history of the disease is essential for the practitioner to identify the prevention levels (Macha et al., 2012). CRC arises from a precursor lesion known as the adenomatous polyp that forms in the field of crypt dysplasia and epithelial cell hyperproliferation. The progression from precursor lesion to colorectal cancer is a multistep process accompanied by alteration of several suppressor genes that results in changes and abnormalities of cell regulation. The progression has a natural history of ten to fifteen years (Pickhardt et al., 2018). Inherited susceptibilities and environmental factors play a major role in the sequence of this process. A better understanding of the various high-risk groups and application of screening methods is essential for individuals and people at average risk.
Colonoscopy has been made available to the intended population over the years and has been significant for screening CRC. More than 15 million colonoscopies are performed annually in the US (Ladabaum et al., 2018). The test became common in 1985 when President Ronald Reagan underwent a life-saving colonoscopy, and the procedure began to garner national attention (Ladabaum et al., 2018). Since then, the procedure has become highly available to most patients and high-risk populations. The number of procedures performed is expected to increase as colonoscopy for screening the asymptomatic population for colorectal cancer continues to elevate. Additionally, colonoscopy is cost-effective; hence a wide range of populations can access the resource.
References
Gunter, M. J., Alhomoud, S., Arnold, M., Brenner, H., Burn, J., Casey, G., & Chanock, S. J. (2019). Meeting report from the joint IARC–NCI international cancer seminar series: A focus on colorectal cancer.Annals of Oncology, 30(4), 510-519. Web.
Kastenberg, D., Bertiger, G., & Brogadir, S. (2018). Bowel preparation quality scales for colonoscopy.World Journal of Gastroenterology, 24(26), 2833. Web.
Ladabaum, U., Mannalithara, A., Meester, R. G., Gupta, S., & Schoen, R. E. (2019). Cost-effectiveness and national effects of initiating colorectal cancer screening for average-risk persons at age 45 years instead of 50 years. Gastroenterology, 157(1), 137-148. Web.
Macha, K., & McDonough, J. (Eds.). (2012). Epidemiology for advanced nursing practice. Jones & Bartlett Publishers.
Pickhardt, P. J., Pooler, B. D., Kim, D. H., Hassan, C., Matkowskyj, K. A., & Halberg, R. B. (2018). The natural history of colorectal polyps: Overview of predictive static and dynamic features.Gastroenterology Clinics, 47(3), 515-536. Web.
Wolf, A. M., Fontham, E. T., Church, T. R., Flowers, C. R., Guerra, C. E., LaMonte, S. J., & Smith, R. A. (2018). Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American cancer society.CA: A Cancer Journal for Clinicians, 68(4), 250-281. Web.