E-Locus - Institutional Repository of the University of Crete - Παράγοντες που προσδιορίζουν την εμφάνιση καρκίνου του παχέος εντέρου σε άτομα ηλικίας κάτω των 50 ετών και ανάλυση της αποτελεσματικότητας των παρεμβάσεων στην Πρωτοβάθμια Φροντίδα Υγείας. Συστηματική Ανασκόπηση

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Identifier

000434852

Title

Παράγοντες που προσδιορίζουν την εμφάνιση καρκίνου του παχέος εντέρου σε άτομα ηλικίας κάτω των 50 ετών και ανάλυση της αποτελεσματικότητας των παρεμβάσεων στην Πρωτοβάθμια Φροντίδα Υγείας. Συστηματική Ανασκόπηση

Alternative Title

Systematic Review. Risk factors that determine the development of colorectal cancer in people under the age of 50 and analysis of the effectiveness of Primary Health Care interventions.

Author

Φωτοπούλου, Ηλέκτρα

Thesis advisor

Λιονής, Χρήστος
Μαυρουδής, Δημήτριος
Σηφάκη-Πιστόλλα Δήμητρα

Abstract

Introduction: Little is known about the risk factors of colorectal cancer in adults under the age of 50, while adherence to Primary Health Care screening programs and their effectiveness remain inadequate. Aim: Initially the identification and analysis of the factors that contribute to colorectal cancer development in young adults as well as research for effective secondary prevention strategies in Primary health care centers. Materials and methods: Systematic review was conducted based on Prisma guidelines. The clinical questions that guided the review were a) What are the factors that contribute to colorectal cancer development in adults under 50 years old compared to a healthy population of the same age and is there a difference between young patients and patients older than 50? and b) Are the organized interventions of the Primary Health Care effective in colorectal cancer secondary prevention? For the first clinical question relevant studies were identified from PubMed and Cochrane database from 2000 to 2019 with study subjects patients with CRC under the age of 50. For the second clinical question relevant studies were identified from Cochrane database from 2009 to 2019 with study subjects adults who participated in organized secondary prevention programs. Results: Twelve studies were included in the former clinical question and 148 in the latter one. Altogether 49 risk factors were identified and classified into 9 categories. The factors that showed significant association with early-onset colorectal cancer were divided into two categories. The first category includes anticipated risk factors such as sex, race/ethnicity and obesity that confer an increased likelihood of colorectal cancer development regardless of age. The factors that were less expected and possibly are associated with high risk of colorectal cancer in young patients, in a decreasing order of importance, are the family history of gastrointestinal malignancy and malignancy of any nature, chronic kidney disease (no dialysis), low intake of citrus fruits, colonic diverticular disease, hypertension and hyperlipidemia. The evaluation of the effectiveness of the colorectal cancer screening interventions yielded six optimal strategies, that met the criteria, and divided in three different intervention categories. Conclusion: Thirty risk factors (24 anticipated, 7 unanticipated) showed a significant association with the early-onset colorectal cancer development. Given the upward trend regarding colorectal cancer in young adults, health care providers should be more vigilant and update the guidelines. Our findings highlight promising strategies that were effective at optimizing colorectal cancer screening.

Language

Greek

Subject

Early- onset

Risk factor

Secondary prevention

Δευτερογενής πρόληψη

Καρκίνος παχέος εντέρου

Παράγοντες κινδύνου

Issue date

2020-12-17

Collection