by dr nahla madan ncd committee april 2010. the working group on the guideline the working group...
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ByDr Nahla MadanNCD Committee
April 2010
The working group on the guidelineThe working Group Reviewing Group
Dr. Ibtihal Al Reefy
Dr. Badryia Yaser Dr. Fathyia
AbdullaDr. Mai BubshaitDr. Basma Al
Tajer
Dr. A. Hussain AL Ajami
Dr. Mariam Al-Jalahma
Dr. Kadhim Jaffer Zaber
Dr. Ali Mirza SalmanDr. Abeer Al Ghawi
Colorectal cancerfactsMajority of colorectal cancer develop from
precancerous changes (polyps) About 90% of patients are over the age of 50Early Colorectal cancers are usually
asymptomaticThe 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 IncludesConstipation/DiarrheaNarrow StoolsAbdominal CrampsBloody StoolsUnexplained Weight Loss/Loss of AppetiteSense of FullnessNausea & VomitingGas & BloatingLethargy (Fatigue)
Colorectal cancer Risk factorsAge >50Personal or family history of colorectal cancer or
adenomatous polypFamilial syndromes as Familial Adenomatous Polyposis
(FAP) or Hereditary Non-polyposis Colorectal Cancer (HNPCC)
H/o inflammatory bowel diseasesHigh animal fat dietTobaccoPhysical 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 interval
Colorectal screening guidelines in PHC For average risk population
Fecal Occult Blood Test (FOBT) annually
andFlexible Sigmoidoscopy every 5
years
Colonoscopy every 10 years
or
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 relative
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 testsColonoscopy 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 PHCA 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 HCShaikh Sabah HCA’ali HCEast Raffa HC
Pilot screening campaign for colorectal cancerThe pilot period will end by using all the test samplesIt is necessary to collect data about the tested
candidates for the future analysis and updating of the guidelines
Collecting data will be by a form filled by the referring physician
After the pilot campaign, guidelines of colorectal cancer screening will be updating and a second awareness session will follow
HEXAGON OBTI Immunochromatographic rapid test
This rapid screening test detects human blood in the stool.
HEXAGON OBTI is a two-part test: - Collection tube for the
blood sample- Test bar
DirectionsUnscrew 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.
DirectionsHold 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 test .
Results
A positive sample is typically detected within 2-3 minutes.
Negative results should be confirmed after 10 minutes.
Interpretation of ResultsA 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 repeated
PositiveNegative 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