scholarly journals Mapping the Colorectal Cancer Screening Scientific Landscape in South Africa: A Bibliometric Analysis to Identify Inequalities

2021 ◽  
Vol 2 (1) ◽  
pp. 27-34
Author(s):  
Magwaza S

Background This paper maps scientific publications to identify areas of CRC screening that are currently receiving greatest emphasis in South African research, as means, to identify the inequality in CRC screening research. Reviewing the publications can assist to identify research funding and research capacity gaps. It can also identify potential for collaboration of authors and institutions to reduce the inequalities. Methods We used bibliometrics to identify and map the scientific publications on CRC screening related to South Africa (SA).The search utilised three databases, namely: Web of Science, Scopus and PubMed to identify articles published between January 2000 to August 2020. We identified the document by type, research areas, journal type, affiliated countries and research organisations, authors with most publications, and funding sources. Results Forty-eight of the 368 publications were included for bibliometric analysis. Of these, there were 88% original articles; 6% were reviews; 4% were books and 2% were abstracts of meetings. The top CRC screening research areas were oncology (21%); gastroenterology and hepatology (13%), public, environmental, occupational health (13%) and genetics and heredity (13%).The top four journals that have published the CRC screening related to South Africa were the South African Medical J. Surgery (10%); South African Medical Journal (7%); Clinical Genetics (5%) and Colorectal Diseases (5%). 19% of articles were published in 2019. There were 28 (58%) articles with first authors from South Africa. There were ten publications without funding declared (21%). The top five research organisations from South Africa that published the most CRC screening research were University of Witwatersrand (36%); University of Western Cape (18%); University of Pretoria (14%); University of Cape Town and KwaZulu-Natal (11%). Conclusion Research and development of novel CRC screening technologies cannot be overemphasised, as catalyst for diverse screening alternatives that are less invasive, affordable and accessible to all those in need to expand access, coverage and increase uptake at local level. Keywords: Colorectal cancer; Bibliometric; Screening; Colonoscopy; Scientific landscape; Inequalities; Cancer; South Africa.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chang Woo Kim ◽  
Hyunjin Kim ◽  
Hyoung Rae Kim ◽  
Bong-Hyeon Kye ◽  
Hyung Jin Kim ◽  
...  

Abstract Background Prevention and early detection of colorectal cancer (CRC) is a global priority, with many countries conducting population-based CRC screening programs. Although colonoscopy is the most accurate diagnostic method for early CRC detection, adherence remains low because of its invasiveness and the need for extensive bowel preparation. Non-invasive fecal occult blood tests or fecal immunochemical tests are available; however, their sensitivity is relatively low. Syndecan-2 (SDC2) is a stool-based DNA methylation marker used for early detection of CRC. Using the EarlyTect™-Colon Cancer test, the sensitivity and specificity of SDC2 methylation in stool DNA for detecting CRC were previously demonstrated to be greater than 90%. Therefore, a larger trial to validate its use for CRC screening in asymptomatic populations is now required. Methods All participants will collect their stool (at least 20 g) before undergoing screening colonoscopy. The samples will be sent to a central laboratory for analysis. Stool DNA will be isolated using a GT Stool DNA Extraction kit, according to the manufacturer’s protocol. Before performing the methylation test, stool DNA (2 µg per reaction) will be treated with bisulfite, according to manufacturer’s instructions. SDC2 and COL2A1 control reactions will be performed in a single tube. The SDC2 methylation test will be performed using an AB 7500 Fast Real-time PCR system. CT values will be calculated using the 7500 software accompanying the instrument. Results from the EarlyTect™-Colon Cancer test will be compared against those obtained from colonoscopy and any corresponding diagnostic histopathology from clinically significant biopsied or subsequently excised lesions. Based on these results, participants will be divided into three groups: CRC, polyp, and negative. The following clinical data will be recorded for the participants: sex, age, colonoscopy results, and clinical stage (for CRC cases). Discussion This trial investigates the clinical performance of a device that allows quantitative detection of a single DNA marker, SDC2 methylation, in human stool DNA in asymptomatic populations. The results of this trial are expected to be beneficial for CRC screening and may help make colonoscopy a selective procedure used only in populations with a high risk of CRC. Trial registration: This trial (NCT04304131) was registered at ClinicalTrials.gov on March 11, 2020 and is available at https://clinicaltrials.gov/ct2/show/NCT04304131?cond=NCT04304131&draw=2&rank=1.


2016 ◽  
Vol 150 (4) ◽  
pp. S456
Author(s):  
David Gibson ◽  
Blathnaid Nolan ◽  
Joanna Rea ◽  
Maire Buckley ◽  
Gareth Horgan ◽  
...  

2006 ◽  
Vol 110 (1114) ◽  
pp. 803-811 ◽  
Author(s):  
L. A. Ingham ◽  
T. Jones ◽  
A. Maneschijn

South Africa has strategic requirements for tasks such as maritime patrol and border control. Research on UAVs should be done in order to design, certify and operate UAVs in civil airspace to satisfy these requirements. If principles such as ‘equivalence’, initially proposed by Eurocontrol are to be adopted in South Africa, it then follows that similar standards used by manned aircraft should be used by UAVs. Similarly, because the process of creating UAV regulations has not kept up with the pace of UAV development, and because dedicated UAV regulations do not yet exist in South Africa, UAVs must be tested and evaluated in order to prove compliance with comparable manned aircraft regulations in the foreseeable future until regulations are created or modified to accommodate UAVs. Given the airspace restrictions, and lack of applicable standards and regulations, proper flight testing of UAVs can become a very specialised task. Most test techniques applied to testing of manned aircraft are fortunately equally applicable to UAVs. This is a research-based paper that provides guidance to flight testers, UAV developers and research organisations wishing to execute tests in South Africa by suggesting a number of considerations for testing of UAVs.


2020 ◽  
Author(s):  
Thomas Heisser ◽  
Rafael Cardoso ◽  
Feng Guo ◽  
Tobias Moellers ◽  
Michael Hoffmeister ◽  
...  

AbstractObjectiveThe performance of colorectal cancer (CRC) screening programs depends on the adherence to screening offers. However, identical adherence levels may result from varying patterns of the population’s screening behavior. We quantified the effects of different adherence patterns on the long-term performance of CRC screening for annual fecal immunochemical testing (FIT) and screening colonoscopy at ten-year intervals.DesignUsing a multistate Markov model, we simulated scenarios where, while at the same overall adherence level, a certain proportion of the population adheres to all screening offers (‘selective’ adherence) or the entire population uses the screening offers at some point(s) of time, albeit not in the recommended frequency (‘sporadic’ adherence). Key outcomes for comparison were the numbers of prevented CRC deaths and prevented years of potential life lost (YPLL) after 50 simulated years.ResultsFor screening with annual FIT at adherence levels of 10-50%, ratios of prevented CRC deaths (YPLL) resulting from a sporadic versus a selective pattern ranged from 1.9-5.0 (1.9-5.0) for men and from 1.8-4.1 (1.8-4.3) for women, i.e. up to 4-5 times more CRC deaths and YPLL were prevented when the population followed a sporadic instead of a selective adherence pattern. Comparisons of simulated scenarios for screening colonoscopy revealed similar patterns.ConclusionAt the same overall level of adherence, ‘sporadic’ adherence patterns go along with much larger preventive effects than ‘selective’ adherence patterns. Screening programs should prioritize efforts to reach as many people as possible at least sporadically over efforts to maximize full adherence to repeat screening offers. Adherence statistics should be refined to better reflect ‘effective adherence’.What You Need to KnowBACKGROUND AND CONTEXTThe evidence on long-term effects of different patterns of longitudinal adherence (e.g. consistent or sporadic uptake) to colorectal cancer screening offers is limited.NEW FINDINGSIn a simulated hypothetical German population, at identical overall participation levels, large proportions of the population making sporadic use of screening offers were up to 4-5 times more beneficial to achieve sustained reductions of colorectal cancer mortality than small proportions of the population utilizing screening offers at the recommended frequency.LIMITATIONSThis study is limited by model simplifying assumptions and uncertainties related to input parameters.IMPACTEfforts to increase screening uptake should be concentrated on groups of consistent non-responders, e.g. by low-threshold screening offerings, such as directly mailed stool tests. Adherence statistics should be refined to better reflect “effective adherence”.SHORT SUMMARYThis simulation study demonstrates that commonly used adherence metrics for colorectal cancer screening do not sufficiently cover the effect of varying patterns of longitudinal adherence, which may considerably impact the long-term efficacy of screening programs.


Author(s):  
Technical Program Committee BroadCom08

South Africa in recent years has continued to create significant excitement in R&D. This excitement is being supported by government, the National Research Fund (NRF), Department of Science and Technology (DST), industry and research organisations with strong collaboration and support from the European Union through its framework programs and the AU. This conference therefore is organised to further report and add impetus to the emerging collaborations and provide researchers the avenue for networking. In 2008 the International conference on wireless broadband and ultra wideband communication) is being hosted by South Africa with stronger and more broad emphasis. The current emphasis reflects the growing interest in new areas of broadband communications. In 2008 the conference is being co-organised by South Africa’s leading research organisations. The core theme of the conference has been expanded to include applications of broadband communications, broadband biomedical applications and biotechnology. The conference is co-organised by the French South African Technical Institute in Electronics (F’SATIE); Tshwane University of Technology (TUT), South Africa; Meraka Institute, South Africa; University of Technology Sydney, Australia, University of Cape Town and the Cape Peninsula University of Technology (CPUT), Cape Town, South Africa and South African National Centre for Informatics, Knowledge Management and Knowledge Economy (SANCIKMKE). All papers submitted to this conference are always peer-reviewed. All accepted papers will be published in the IEEE Xplore digital library and the best papers from the conference will be published as a book of best papers by River Publishers of Denmark (as in 2007). Other short-listed papers will also be published in a special edition of the African Journal of Information and Communication Technology (AJICT).


2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 419-419 ◽  
Author(s):  
Gunter Weiss ◽  
Anne Fassbender ◽  
Thomas Koenig ◽  
Reimo Tetzner

419 Background: Early detection of colorectal cancer (CRC) has been shown to decrease mortality, although compliance to CRC screening is low. Availability of a blood-based test is expected to improve CRC screening compliance. Specific detection of CRC using the Septin9 biomarker (mSEPT9) in a large prospective trial of an average-risk CRC screening population exhibited 67% sensitivity for CRC with 88% specificity. Laboratory-developed tests detecting mSEPT9 in plasma are now available in North America and a 2nd generation molecular diagnostic blood test for mSEPT9 is available as a CE-marked kit in Europe. The current research evaluated the clinical performance of the 2nd generation mSEPT9 assay. Methods: Bisulfite-converted DNA (bisDNA) was prepared from 3.5 mL human plasma using the 2ndgeneration plasma DNA preparation kit. Resulting bisDNA was analyzed in triplicate on the ABI7500 Fast Dx (Life Technologies, Inc.) using proprietary HeavyMethyl real-time PCR technology for mSEPT9 and the 2nd generation real-time PCR kit. In a case – control design, plasma from 98 CRC patients (n = 87 stages I - III) and 99 age-matched, colonoscopy-verified normal individuals were processed with the mSEPT9 assay. In addition, plasma from 150 prospectively enrolled average risk individuals scheduled for screening colonoscopy was tested. mSEPT9 was qualitatively analyzed such that any detection of mSEPT9 in a PCR was called “positive”. Results: The revised mSEPT9 assay exhibited 95% sensitivity (95% CI: 89-98%) for CRC. Sensitivity for stage I was 89% (95% CI: 72-96%, n = 27) and sensitivity for stage II was 93% (95% CI: 78-98%, n = 29). The control group was positive at a rate of 16% (95% CI: 10-25%). Specificity of the mSEPT9 assay in the screening cohort was 85% (95% CI: 78-89%). Conclusions: The 2nd generation mSEPT9 assay demonstrated improved sensitivity for CRC without significant impact on specificity. The enhanced design and robustness of the assay will further facilitate its standardized use in routine laboratory settings. Finally, the increased sensitivity of the revised mSEPT9 assay improves the detection of early stage disease and demonstrates the feasibility of a blood-based CRC screening technology.


2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 431-431 ◽  
Author(s):  
Sowjanya Kanna ◽  
Asif Ali ◽  
Kiran Anna ◽  
Thimmaiah Theethira Ganapathi ◽  
Raja Shekhar Reddy Sappati Biyyani ◽  
...  

431 Background: Colorectal cancer (CRC) is the second most common cancer with an estimated incidence of 72,090 men and 70,480 women and a cause specific mortality of 51,370 in 2010. Despite promotion of CRC screening by various professional societies ACG /AGA and USPSTF, there seems to be an under utilization of screening colonoscopy for unclear reasons. We aimed to study the awareness of physicians towards CRC screening across various levels of training in different specialities. Methods: A survey questionnaire of 16 questions, assessing awareness of CRC screening guidelines was provided to 100 physicians in our academic medical center who are at various levels of training in Primary Care Group (PCG comprising residents, attending physicians in Internal Medicine and Family Medicine) and Specialty Group (SG comprising fellows, attending physicians in Gastroenterology). Results: Out of 100 questionnaires, we received 59 responses (50 PCG and 9 SG) which are included in the results. About 54% of the study group followed CRC guidelines (32% USPSTF CRC screening guidelines compared to 22 % ACG/AGA guidelines) and 46% did not. All the physicians who did not follow the guidelines belonged to the PCG. Most common screening modality chosen was colonoscopy alone (46% PCG and 100% SG), followed by colonoscopy with FOBT (36% PCG), FOBT (12% PCG) and 3% PCG answered barium enema along with FOBT/ sigmoidoscopy. A 100% response from both SG and PCG was obtained for commencing screening colonoscopy at 50 years of age but only 27% of the PCG compared to 80% SG were aware of the screening cessation guidelines. Interestingly a vast majority of the study group (88%) text messaging as a better way of reminder to improve compliance compared to phone calls and postal letters. About 72% of the respondents themselves would want colonoscopy as screening modality compared to 17% for FOBT and 7% for sigmoidoscopy. An overwhelming majority of the study group (80% of both PCG and SG) felt the need for continued education in regards to guidelines for screening in didactic sessions. Conclusions: Despite clear guidelines for screening colonoscopy, we found a significant lack of awareness amongst PCG compared to SG, and our study emphasizes the need for continued education.


2010 ◽  
Vol 06 (01) ◽  
pp. 51 ◽  
Author(s):  
Gunter Weiss ◽  
Thomas Rösch ◽  
◽  

Despite clear evidence for a better prognosis when detected early, in most countries colorectal cancer (CRC) has a low compliance rate in terms of screening. There are several methods of CRC screening ranging from a variety of stool tests, e.g. faecal occult blood test (FOBT), to endoscopy (sigmoidoscopy, colonoscopy). A blood test for CRC detection is a new alternative, at least for patients not willing to accept screening colonoscopy or to undergo FOBT. The septin 9 biomarker is a potential candidate to fulfil this purpose. It has been validated in several case–control studies, showing a strong association of plasma-containing methylated DNA within the septin 9 gene (mSEPT9) with the presence of CRC. If sensitive methylated-DNA-detection technologies are used formSEPT9 detection in blood plasma samples, sensitivities of about 50% for stage I, 70–80% for stages II and III and 90–100% for stage IV at a specificity of ≥90% have been reported in these studies. Screening experts assume that such a blood-based test will increase compliance to CRC screening. Further studies are ongoing or have just been completed, including a large prospective screening trial involving 8,000 individuals in the US and Germany. The main objectives of this clinical investigation, called Prospective Evaluation of Septin 9 Performance for Colorectal Cancer Screening (PRESEPT), are to determine the performance of the septin 9 test for identification of CRC in a screening population and to demonstrate the health economic benefit of septin 9 in this setting. Results are expected in April 2010. This article presents an update on current analytical and clinical data onmSEPT9.


2012 ◽  
Vol 30 (32) ◽  
pp. 3947-3952 ◽  
Author(s):  
John Bian ◽  
Charles L. Bennett ◽  
Deborah A. Fisher ◽  
Maria Ribeiro ◽  
Joseph Lipscomb

Purpose We evaluated the Colorectal Cancer (CRC) Oncology Watch intervention, a clinical reminder implemented in Veterans Integrated Service Network 7 (including eight hospitals) to improve CRC screening rates in 2008. Patients and Methods Veterans Affairs (VA) administrative data were used to construct four cross-sectional groups of veterans at average risk, age 50 to 64 years; one group was created for each of the following years: 2006, 2007, 2009, and 2010. We applied hospital fixed effects for estimation, using a difference-in-differences model in which the eight hospitals served as the intervention sites, and the other 121 hospitals served as controls, with 2006 to 2007 as the preintervention period and 2009 to 2010 as the postintervention period. Results The sample included 4,352,082 veteran-years in the 4 years. The adherence rates were 37.6%, 31.6%, 34.4%, and 33.2% in the intervention sites in 2006, 2007, 2009, and 2010, respectively, and the corresponding rates in the controls were 31.0%, 30.3%, 32.3%, and 30.9%. Regression analysis showed that among those eligible for screening, the intervention was associated with a 2.2–percentage point decrease in likelihood of adherence (P < .001). Additional analyses showed that the intervention was associated with a 5.6–percentage point decrease in likelihood of screening colonoscopy among the adherent, but with increased total colonoscopies (all indicators) of 3.6 per 100 veterans age 50 to 64 years. Conclusion The intervention had little impact on CRC screening rates for the studied population. This absence of favorable impact may have been caused by an unintentional shift of limited VA colonoscopy capacity from average-risk screening to higher-risk screening and to CRC surveillance, or by physician fatigue resulting from the large number of clinical reminders implemented in the VA.


2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Sibel Saya ◽  
Jon D Emery ◽  
James G Dowty ◽  
Jennifer G McIntosh ◽  
Ingrid M Winship ◽  
...  

Abstract Background In many countries, population colorectal cancer (CRC) screening is based on age and family history, though more precise risk prediction could better target screening. We examined the impact of a CRC risk prediction model (incorporating age, sex, lifestyle, genomic, and family history factors) to target screening under several feasible screening scenarios. Methods We estimated the model’s predicted CRC risk distribution in the Australian population. Predicted CRC risks were categorized into screening recommendations under 3 proposed scenarios to compare with current recommendations: 1) highly tailored, 2) 3 risk categories, and 3) 4 sex-specific risk categories. Under each scenario, for 35- to 74-year-olds, we calculated the number of CRC screens by immunochemical fecal occult blood testing (iFOBT) and colonoscopy and the proportion of predicted CRCs over 10 years in each screening group. Results Currently, 1.1% of 35- to 74-year-olds are recommended screening colonoscopy and 56.2% iFOBT, and 5.7% and 83.2% of CRCs over 10 years were predicted to occur in these groups, respectively. For the scenarios, 1) colonoscopy was recommended to 8.1% and iFOBT to 37.5%, with 36.1% and 50.1% of CRCs in each group; 2) colonoscopy was recommended to 2.4% and iFOBT to 56.0%, with 13.2% and 76.9% of cancers in each group; and 3) colonoscopy was recommended to 5.0% and iFOBT to 54.2%, with 24.5% and 66.5% of cancers in each group. Conclusions A highly tailored CRC screening scenario results in many fewer screens but more cancers in those unscreened. Category-based scenarios may provide a good balance between number of screens and cancers detected and are simpler to implement.


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