Objective. The aim of the study was to estimate the prevalence of hereditary cancers and the need for surveillance in Telemark county, Norway. Material and methods. All persons attending the Norwegian Colorectal Cance...Objective. The aim of the study was to estimate the prevalence of hereditary cancers and the need for surveillance in Telemark county, Norway. Material and methods. All persons attending the Norwegian Colorectal Cancer Prevention (NORCCAP) trial in Telemark were interviewed about cases of cancer in the family. Diagnoses were verified, pedigrees constructed and families classified according to preset criteria aiming at identifying hereditary cancer. Mutation analyses were performed in kindreds at risk for breast cancers when possible. Immunohistochemistry of tumors in assumed inherited colorectal cancer families was undertaken. Results. The screening examination was attended by 7224 persons among whom 2866 had cancer in the family. Of these, 2479 had no suspicion of any known inherited cancer syndrome. Family information questionnaires were mailed to 387 persons and returned by 191. Sixty-four of these 191 met the clinical criteria for familial cancer by family history after verification of diagnoses. Observed prevalences for being at risk for hereditary breast and breast-ovarian cancer (HBOC) or hereditary non-polyposis colorectal cancer (HNPCC) were 2.8‰and 0.77‰, respectively. Conclusions. The number of colonos-copies and mammograms obtained per year serving those who needed them was limited and reduced by clinical genetic work-up from 2866 with a family history of cancer to 64 proven cases. Continued surveillance of an unnecessarily high number leads to unjustified cancer worry, is costly and uses up health-care facilities. Genetic work-up is a one-time job that reduces input numbers to surveillance programs, provides a starting-point for mutation testing and is economically cost beneficial if inherited cancers are prevented or cured by the health-care programs offered.展开更多
Background and study aims: A new colonoscope (XCFQ-160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. ...Background and study aims: A new colonoscope (XCFQ-160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. In this study we investigated whether this function could be included in a standard colonoscope without jeopardizing general performance, particularly passage through the sigmoid colon. Patients and methods: 280 outpatients referred for routine colonoscopy at Telemark Hospital were randomly allocated to colonoscopy with a standard colonoscope (Olympus 140 series) or the XCFQ160AW prototype. Sedation was given on demand. End points were cecal intubation and the patients’grading of pain in a questionnaire. Results: Cecal intubation rates were 85 %and 87 %for standard and prototype endoscopes, respectively (P=0.57). On-demand sedation was given to nine (7%) and 15 (11%) of the patients, respectively (P=0.17). Of the patients, 256 (85%) returned their questionnaire,with 87 (63%) in the standard group and 109 (77%) in the prototype group reporting that they had experienced ‘no pain/slight pain’(P < 0.001). In a multiple logistic regression analysis, this difference in experienced pain remained statistically significant after adjustment for interendoscopist variation and the use of the endoscope-stiffening function. Two patients in the study, in whom there had previously been several unsuccessful attempts at negotiating the splenic flexure, were successfully examined with the prototype colonoscope. Conclusion: Examination with the Olympus XCF-Q160AW prototype with a passive bending function caused less pain than use of a standard Olympus 140 series colonoscope, without compromising other endoscope functions for colonic intubation.展开更多
文摘Objective. The aim of the study was to estimate the prevalence of hereditary cancers and the need for surveillance in Telemark county, Norway. Material and methods. All persons attending the Norwegian Colorectal Cancer Prevention (NORCCAP) trial in Telemark were interviewed about cases of cancer in the family. Diagnoses were verified, pedigrees constructed and families classified according to preset criteria aiming at identifying hereditary cancer. Mutation analyses were performed in kindreds at risk for breast cancers when possible. Immunohistochemistry of tumors in assumed inherited colorectal cancer families was undertaken. Results. The screening examination was attended by 7224 persons among whom 2866 had cancer in the family. Of these, 2479 had no suspicion of any known inherited cancer syndrome. Family information questionnaires were mailed to 387 persons and returned by 191. Sixty-four of these 191 met the clinical criteria for familial cancer by family history after verification of diagnoses. Observed prevalences for being at risk for hereditary breast and breast-ovarian cancer (HBOC) or hereditary non-polyposis colorectal cancer (HNPCC) were 2.8‰and 0.77‰, respectively. Conclusions. The number of colonos-copies and mammograms obtained per year serving those who needed them was limited and reduced by clinical genetic work-up from 2866 with a family history of cancer to 64 proven cases. Continued surveillance of an unnecessarily high number leads to unjustified cancer worry, is costly and uses up health-care facilities. Genetic work-up is a one-time job that reduces input numbers to surveillance programs, provides a starting-point for mutation testing and is economically cost beneficial if inherited cancers are prevented or cured by the health-care programs offered.
文摘Background and study aims: A new colonoscope (XCFQ-160AW prototype, Olympus, Tokyo, Japan) has been developed, designed with an additional passive bending function to ease intubation through the left colonic flexure. In this study we investigated whether this function could be included in a standard colonoscope without jeopardizing general performance, particularly passage through the sigmoid colon. Patients and methods: 280 outpatients referred for routine colonoscopy at Telemark Hospital were randomly allocated to colonoscopy with a standard colonoscope (Olympus 140 series) or the XCFQ160AW prototype. Sedation was given on demand. End points were cecal intubation and the patients’grading of pain in a questionnaire. Results: Cecal intubation rates were 85 %and 87 %for standard and prototype endoscopes, respectively (P=0.57). On-demand sedation was given to nine (7%) and 15 (11%) of the patients, respectively (P=0.17). Of the patients, 256 (85%) returned their questionnaire,with 87 (63%) in the standard group and 109 (77%) in the prototype group reporting that they had experienced ‘no pain/slight pain’(P < 0.001). In a multiple logistic regression analysis, this difference in experienced pain remained statistically significant after adjustment for interendoscopist variation and the use of the endoscope-stiffening function. Two patients in the study, in whom there had previously been several unsuccessful attempts at negotiating the splenic flexure, were successfully examined with the prototype colonoscope. Conclusion: Examination with the Olympus XCF-Q160AW prototype with a passive bending function caused less pain than use of a standard Olympus 140 series colonoscope, without compromising other endoscope functions for colonic intubation.
