Managing Surveillance for Colorectal Cancer: The Importance of Microcomputers View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

1990

AUTHORS

F. A. Macrae , D. J. B. St. John , E. Muir , S. McPherson

ABSTRACT

Large scale screening programmes for colorectal cancer based on genetic risk are difficult to administer because of the need to identify at-risk family members and ensure that surveillance proceeds in an orderly fashion over a lifetime. As at August 1989, 1100 high risk persons have been registered with the Royal Melbourne Hospital Surveillance Programme. Categorisation of risk is done after evaluation of the family’s history of cancer. Surveillance protocols are then defined based on the intensity of cancer in the family. Annual occult blood testing is performed in all groups. Colonoscopy is performed every 2 years on at-risk members of families with hereditary non-polyposis colon cancer syndromes (n = 35 families) and 3 to 5 yearly for individuals with two or more first-degree relatives with sporadic colorectal cancer. Flexible sigmoidoscopy is performed every 3 years on some individuals with one affected first-degree relative, particularly where there are other affected relatives more remotely placed in the family. Patients who have had an adenoma/cancer undergo 3-yearly colonoscopy. ScreeningMan is a menu-driven microcomputer program which documents cancer risk, organises surveillance, identifies non-compliers, notifies negative results to participants and their doctors, and documents and analyses the results of surveillance as scheduled. In this paper, we compare the efficiency of ScreeningMan with a wordprocessor system and a correctible typewriter system. Personnel time required to administer initial and subsequent surveillance with faecal occult blood testing (FOBT) and colonoscopy was measured for each approach. For ScreeningMan, a database was entered initially and sequential results added directly to the computer; letters were then produced by list-processing. With the Wordprocessing and Typing systems, cards were retrieved and results entered for each contact. Despite time overheads required for data entry, ScreeningMan handled surveillance administration more rapidly than the manual systems, even with as few as 10 subjects. When 1000 subjects are involved, the computer system was more than twice as quick as either of the other systems. Provided the database is maintained accurately, a computer system offers efficiency, security of follow-up, personalised correspondence and an analysable database for the effective function of a high-risk register. More... »

PAGES

175-183

Book

TITLE

Hereditary Colorectal Cancer

ISBN

978-4-431-68339-1
978-4-431-68337-7

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-4-431-68337-7_28

DOI

http://dx.doi.org/10.1007/978-4-431-68337-7_28

DIMENSIONS

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