Colorectal cancer screening guidelines by ov70Wv87


Dr Nahla Madan
NCD Committee
   April 2010
The working group on the
The working Group        Reviewing Group
                          Dr. A. Hussain AL Ajami
 Dr. Ibtihal Al Reefy
 Dr. Badryia Yaser       Dr. Mariam Al-Jalahma
 Dr. Fathyia Abdulla     Dr. Kadhim Jaffer Zaber
 Dr. Mai Bubshait        Dr. Ali Mirza Salman
 Dr. Basma Al Tajer      Dr. Abeer Al Ghawi
Colorectal cancer
 Majority of colorectal cancer develop from
  precancerous changes (polyps)
 About 90% of patients are over the age of 50
 Early Colorectal cancers are usually
 The average duration of symptoms (from onset
  to diagnosis) is 14 weeks. There is no
  association between overall duration of
  symptoms and the stage of the tumor
Symptoms of Colorectal Cancer
May Includes:
 Constipation/Diarrhea
 Narrow Stools
 Abdominal Cramps
 Bloody Stools
 Unexplained Weight Loss/Loss of Appetite
 Sense of Fullness
 Nausea & Vomiting
 Gas & Bloating
 Lethargy (Fatigue)
Colorectal cancer
Risk factors
 Age >50
 Personal or family history of colorectal cancer or
    adenomatous polyp
   Familial syndromes as Familial Adenomatous Polyposis
    (FAP) or Hereditary Non-polyposis Colorectal Cancer
   H/o inflammatory bowel diseases
   High animal fat diet
   Tobacco
   Physical inactivity
Colorectal screening guidelines in
PHC For average risk population

Screening starts at the age of 50-
 90 or until there is a 30% chance
 of living to the next screening
Colorectal screening guidelines in
PHC For average risk population
      Fecal Occult Blood Test (FOBT)
   Flexible Sigmoidoscopy every 5 years


        Colonoscopy every 10 years
Colorectal screening guidelines in
PHC For High risk population
 Screening start at the age of 40 or 10 years
  before the age of cancer in the first degree
 First degree relative: Any relative who is one
  meiosis away from a particular individual in a
  family (i.e., parent, sibling, offspring)
Colorectal screening guidelines in
PHC For special risk population

 Patients with hereditary colorectal cancer
  syndrome should undergo annual colonoscopy
 Patients with Ulcerative Colitis or Crohn’s
  Colitis of 7-10 years duration should start
  colonoscopy screening every 1-3 years
Colorectal Screening tests
 Colonoscopy is the most sensitive and specific
  test of the all available screening tests of
  colorectal cancer
 FOBT has the most direct evidence of reducing
  colorectal cancer mortality
 The sensitivity of sigmoidoscopy as a screening
  tests affected by type of the instrument
What is available in PHC
 A pilot screening campaign will be started using
  HEXAGON OBTI to test stool for human blood in all
  adult 50-90 years of age attending LHC
 The available test sample for the pilot campaign is
 500, and will be distributed in the following HC:
    Muharraq HC

    Shaikh Sabah HC

    A’ali HC

    East Raffa HC
Pilot screening campaign for
colorectal cancer
 The pilot period will end by using all the test samples
 It is necessary to collect data about the tested
  candidates for the future analysis and updating of the
 Collecting data will be by a form filled by the referring
 After the pilot campaign, guidelines of colorectal
  cancer screening will be updating and a second
  awareness session will follow
Immunochromatographic rapid test

This rapid screening test
detects human blood in the

HEXAGON OBTI is a two-
part test:
- Collection tube for the
   blood sample
- Test bar
 Unscrew the cap of the tube and collect the
 sample with the applicator stick by taking
 several postions at different sites (3-4) of the
 faeces . Remove excess stool with a tissue.
 Reinsert the applicator stick into the tube. This
 sample collected is stable at room
 temperature and must be tested within one
 week after collection.

 With the lid screwed back on, shake the
 sample gently inside the transport medium to
 assure proper mixing.
Hold the tube with the red
end upwards and break-off
the tip.

Dispense exactly 2 full
drops, drop by drop, into
the test in the sample well
(S) at the lower end of the

A positive sample is
typically detected within
2-3 minutes.

Negative results should be
confirmed after
10 minutes.
Interpretation of Results
 A single blue line
  means the testing
  liquid is working fine,
  but no human blood
  has been detected. It is
  called a “control line“
 Two blue lines mean
  the test has detected
  human blood (even if
  blue color is weak)
 No control line means
  that the test should be
Negative   Positive   Invalid
Other features

  The test kit is stable up to
   the given expiration date
   when stored at 2 – 25 oC
  Dietary restrictions are
   not necessary
      Thank You
and hope you a good day

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