scholarly journals Diagnostic accuracy of follow‐up tests for detecting colorectal cancer recurrences in primary care: A systematic review and meta‐analysis

2021 ◽  
Author(s):  
Geertje B. Liemburg ◽  
Daan Brandenbarg ◽  
Marjolein Y. Berger ◽  
Saskia F.A. Duijts ◽  
Gea A. Holtman ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Primary Care ◽  
Diagnostic Accuracy ◽  
Meta Analysis

scholarly journals Diagnostic and Prognostic Significance of MiR-150 in Colorectal Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 10 (3) ◽  
pp. 99
Author(s):  
Daniel Sur ◽  
Claudia Burz ◽  
Shanthi Sabarimurugan ◽  
Alexandru Irimie
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Treatment Options ◽  
Prognostic Significance ◽  
High Specificity ◽  
Diagnostic Biomarker ◽  
Specificity And Sensitivity

Although treatment options have improved, the survival and quality of life of colorectal cancer (CRC) patients remain dismal. Therefore, significant biomarker prediction may help to improve colorectal cancer patient’s prognosis profile. MiRNAs have come as an option because of their essential role in cancer initiation and progression by regulating several molecular processes. MiR-150 has different roles in cancer, but its function in CRC is still ambiguous. We undertook a systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) research criteria by interrogating several databases in order to assess the diagnostic accuracy and prognostic value of miR-150. Additionally, clinicalgov.org was scanned for possible trials. The literature was screened from inception to February 2020. A total of 12 out of 70 full-text articles were included in the meta-analysis. Among these, nine studies were included for diagnostic accuracy, and the remaining three were considered for prognostic significance of miR-150. With our results, miR-150 is an appropriate diagnostic biomarker, especially in serum and plasma, while the prognostic value of miR-150 was not statistically significant. The present study findings suggest that miR-150 has high specificity and sensitivity values as a potential diagnostic biomarker in colorectal cancer patients.

scholarly journals Value of symptoms and additional diagnostic tests for colorectal cancer in primary care: systematic review and meta-analysis

BMJ ◽  
2010 ◽  
Vol 340 (mar31 3) ◽  
pp. c1269-c1269 ◽  
Author(s):  
P. Jellema ◽  
D. A. W. M. van der Windt ◽  
D. J. Bruinvels ◽  
C. D. Mallen ◽  
S. J. B. van Weyenberg ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Primary Care ◽  
Diagnostic Tests ◽  
Meta Analysis

scholarly journals Promoting physical activity in primary care: a systematic review and meta-analysis

2021 ◽  
pp. BJGP.2020.0817
Author(s):  
Veronika van der Wardt ◽  
Claudio di Lorito ◽  
Annika Viniol
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Primary Care ◽  
Meta Analysis ◽  
Physical Activity Behaviour ◽  
External Support ◽  
Phone Calls ◽  
Activity Promotion ◽  
Wide Range

BackgroundPromoting physical activity is an important part of patient care in primary care and has been investigated in many studies with a wide range of intervention characteristics, often including external support. It is unclear, however, if promoting physical activity is effective.AimTo investigate the effectiveness of behaviour change interventions to promote physical activity in primary care.Design and settingThis is a systematic review and meta-analysis to evaluate physical activity promotion in a primary care setting.MethodEMBASE, MEDLINE, PsycInfo, and the Joanna Briggs Institute Database were searched for ‘physical activity’, ‘interview’, ‘motivation’, ‘primary care’, and equivalent words to identify randomised controlled trials with physical activity as the outcome at patient level.ResultsThe review identified 24 eligible studies. The quality appraisal showed that most studies reported insufficient details regarding randomisation, group allocation, blinding, and fidelity of intervention delivery. The included studies reported a wide range of interventions with varying numbers of follow-up visits or phone calls. The overall effect size for interventions with a 6-month follow-up interval was 0.04 (95% confidence interval [CI] = −0.06 to 0.14), and for interventions with a 12-month follow-up interval it was 0.20 (95% CI = 0.04 to 0.36). Only one intervention based on three motivational interviewing sessions achieved a moderate effect.ConclusionCounselling to promote physical activity in primary care has a limited effect on patients’ behaviour and it might not, on its own, be enough to change physical activity behaviour.

scholarly journals What carcinoembryonic antigen level should trigger further investigation during colorectal cancer follow-up? A systematic review and secondary analysis of a randomised controlled trial

2017 ◽  
Vol 21 (22) ◽  
pp. 1-60 ◽  
Author(s):  
Bethany Shinkins ◽  
Brian D Nicholson ◽  
Tim James ◽  
Indika Pathiraja ◽  
Sian Pugh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Carcinoembryonic Antigen ◽  
Cochrane Review ◽  
Secondary Analysis ◽  
False Alarms ◽  
Positive Trend ◽  
Test Result

Background Following primary surgical and adjuvant treatment for colorectal cancer, many patients are routinely followed up with blood carcinoembryonic antigen (CEA) testing. Objective To determine how the CEA test result should be interpreted to inform the decision to undertake further investigation to detect treatable recurrences. Design Two studies were conducted: (1) a Cochrane review of existing studies describing the diagnostic accuracy of blood CEA testing for detecting colorectal recurrence; and (2) a secondary analysis of data from the two arms of the FACS (Follow-up After Colorectal Surgery) trial in which CEA testing was carried out. Setting and participants The secondary analysis was based on data from 582 patients recruited into the FACS trial between 2003 and 2009 from 39 NHS hospitals in England with access to high-volume services offering surgical treatment of metastatic recurrence and followed up for 5 years. CEA testing was undertaken in general practice. Results In the systematic review we identified 52 studies for meta-analysis, including in aggregate 9717 participants (median study sample size 139, interquartile range 72–247). Pooled sensitivity at the most commonly recommended threshold in national guidelines of 5 µg/l was 71% [95% confidence interval (CI) 64% to 76%] and specificity was 88% (95% CI 84% to 92%). In the secondary analysis of FACS data, the diagnostic accuracy of a single CEA test was less than was suggested by the review [area under the receiver operating characteristic curve (AUC) 0.74, 95% CI 0.68 to 0.80]. At the commonly recommended threshold of 5 µg/l, sensitivity was estimated as 50.0% (95% CI 40.1% to 59.9%) and lead time as about 3 months. About four in 10 patients without a recurrence will have at least one false alarm and six out of 10 tests will be false alarms (some patients will have multiple false alarms, particularly smokers). Making decisions to further investigate based on the trend in serial CEA measurements is better (AUC for positive trend 0.85, 95% CI 0.78 to 0.91), but to maintain approximately 70% sensitivity with 90% specificity it is necessary to increase the frequency of testing in year 1 and to apply a reducing threshold for investigation as measurements accrue. Limitations The reference standards were imperfect and the main analysis was subject to work-up bias and had limited statistical precision and no external validation. Conclusions The results suggest that (1) CEA testing should not be used alone as a triage test; (2) in year 1, testing frequency should be increased (to monthly for 3 months and then every 2 months); (3) the threshold for investigating a single test result should be raised to 10 µg/l; (4) after the second CEA test, decisions to investigate further should be made on the basis of the trend in CEA levels; (5) the optimal threshold for investigating the CEA trend falls over time; and (6) continuing smokers should not be monitored with CEA testing. Further research is needed to explore the operational feasibility of monitoring the trend in CEA levels and to externally validate the proposed thresholds for further investigation. Study registration This study is registered as PROSPERO CRD42015019327 and Current Controlled Trials ISRCTN93652154. Funding The main FACS trial and this substudy were funded by the National Institute for Health Research Health Technology Assessment programme.

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