Outcomes and appropriateness of colonoscopy referrals at King Khalid University Hospital, Saudi Arabia: An opportunity to expand the colonoscopy screening

Shahad M. AlQahtani; Sulaiman A. Alshammari; Reem J. Khidir; Maha F. AlKhunaizi; Osama M. Abdulqader

doi:10.15537/smj.2023.44.11.20230378

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2. Laversanne M,
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OpenUrl CrossRef PubMed
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1. Xi Y,
2. Xu P
. Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol 2021; 14: 101174.
OpenUrl CrossRef PubMed
3.↵
1. Sung H,
2. Ferlay J,
3. Siegel RL,
4. Laversanne M,
5. Soerjomataram I,
6. Jemal A, et al.
Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71: 209–249.
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4.↵
1. Alqahtani MZ,
2. Mohammed AG,
3. Alsamghan AS,
4. Bharti RK,
5. Alsharm AA,
6. Alshahrani MT, et al.
Risk factors of colorectal cancer among Saudi population: case-control study. J Family Med Prim Care 2020; 9: 5035–5040.
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5.↵
1. Almatroudi A
. The incidence rate of colorectal cancer in Saudi Arabia: an observational descriptive epidemiological analysis. Int J Gen Med 2020; 13: 977–990.
OpenUrl CrossRef PubMed
6.↵
1. Gupta S
. Screening for colorectal cancer. Hematol Oncol Clin North Am 2022; 36: 393–414.
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7.↵
1. Bretthauer M,
2. Løberg M,
3. Wieszczy P,
4. Kalager M,
5. Emilsson L,
6. Garborg K, et al.
Effect of colonoscopy screening on risks of colorectal cancer and related death. N Engl J Med 2022; 387: 1547–1556.
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8.↵
1. Stewart DB
. Updated USPSTF guidelines for colorectal cancer screening: the earlier the better. JAMA Surg 2021; 156: 708–709.
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1. Latos W,
2. Aebisher D,
3. Latos M,
4. Krupka-Olek M,
5. Dynarowicz K,
6. Chodurek E, et al.
Colonoscopy: preparation and potential complications. Diagnostics (Basel) 2022; 12: 747.
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10.↵
1. Kanth P,
2. Inadomi JM
. Screening and prevention of colorectal cancer. BMJ 2021; 374: n1855.
OpenUrl Abstract/FREE Full Text
11.↵
1. Montminy EM,
2. Karlitz JJ,
3. Landreneau SW
. Progress of colorectal cancer screening in United States: past achievements and future challenges. Prev Med 2019; 120: 78–84.
OpenUrl CrossRef PubMed
12.↵
1. Safiri S,
2. Sepanlou SG,
3. Ikuta KS,
4. Bisignano C,
5. Salimzadeh H,
6. Delavari A, et al.
The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol 2019; 4: 913–933.
OpenUrl
13.↵
1. Ali Asgari A,
2. Sazgarnejad S,
3. Haghdoost B,
4. Ghasemi Tirtashi M,
5. Sadeghi A,
6. Malekzadeh R
. Colonoscopy complications in an Iranian teaching hospital. Middle East J Dig Dis 2022; 14: 51–56.
OpenUrl
14.↵
1. Zullo A,
2. Manta R,
3. De Francesco V,
4. Fiorini G,
5. Hassan C,
6. Vaira D
. Diagnostic yield of upper endoscopy according to appropriateness: a systematic review. Dig Liver Dis 2019; 51: 335–339.
OpenUrl
15.↵
1. Frazzoni L,
2. La Marca M,
3. Radaelli F,
4. Spada C,
5. Laterza L,
6. Zagari RM, et al.
Systematic review with meta-analysis: the appropriateness of colonoscopy increases the probability of relevant findings and cancer while reducing unnecessary exams. Aliment Pharmacol Ther 2021; 53: 22–32.
OpenUrl PubMed
16.↵
1. Li N,
2. Lu B,
3. Luo C,
4. Cai J,
5. Lu M,
6. Zhang Y, et al.
Incidence, mortality, survival, risk factor and screening of colorectal cancer: a comparison among China, Europe, and northern America. Cancer Lett 2021; 522: 255–268.
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17.↵
1. Kerrison RS,
2. Sheik-Mohamud D,
3. McBride E,
4. Whitaker KL,
5. Rees C,
6. Duffy S, et al.
Patient barriers and facilitators of colonoscopy use: a rapid systematic review and thematic synthesis of the qualitative literature. Prev Med 2021; 145: 106413.
OpenUrl
18.↵
The American Society for Gastrointestinal Endoscopy. ASGE guidelines. [Updated 2023; accessed 2023 Jan 23]. Available from: https://www.asge.org/home/resources/key-resources/guidelines#newly-published
19.↵
1. Makhlouf NA,
2. Abdel-Gawad M,
3. Mahros AM,
4. Lashen SA,
5. Zaghloul M,
6. Eliwa A, et al.
Colorectal cancer in Arab world: a systematic review. World J Gastrointest Oncol 2021; 13: 1791–1798.
OpenUrl
20.↵
1. Alyabsi M,
2. Algarni M,
3. Alshammari K
. Trends in colorectal cancer incidence rates in Saudi Arabia (2001-2016) using Saudi National Registry: early- versus late-onset disease. Front Oncol 2021; 11: 730689.
OpenUrl CrossRef PubMed
21.↵
1. Jabar MF,
2. Halim ME,
3. Gul YA
. Appropriateness of colonoscopy in a tertiary referral centre. Asian J Surg 2004; 27: 26–31.
OpenUrl PubMed
22.↵
1. O’Sullivan JW,
2. Albasri A,
3. Nicholson BD,
4. Perera R,
5. Aronson JK,
6. Roberts N, et al.
Overtesting and undertesting in primary care: a systematic review and meta-analysis. BMJ Open 2018; 8: e018557.
OpenUrl Abstract/FREE Full Text
23.
1. Odeghe EA,
2. Oluyemi AO,
3. Adeniyi OF
. Appropriate use of colonoscopy in Nigeria: a retrospective study using the American Society for Gastrointestinal Endoscopy (ASGE) 2012 guidelines. PAMJ - One Health 2020; 2.
24.↵
1. Kapila N,
2. Singh H,
3. Kandragunta K,
4. Castro FJ
. Open access colonoscopy for colorectal cancer prevention: an evaluation of appropriateness and quality. Dig Dis Sci 2019; 64: 2798–2805.
OpenUrl
25.↵
International Agency for Research on Cancer, World Health Organization. Saudi Arabia - global cancer observatory. [Updated 2020; accessed 2023 Aug 1]. Available from: https://gco.iarc.fr/today/data/factsheets/populations/682-saudi-arabia-fact-sheets.pdf
26.↵
Ministry Of Health. Colorectal cancer early detection. [Updated 2021; accessed 2023 Aug 1]. Available from: https://moh.gov.sa/en/Ministry/Projects/Colorectal-Cancer-Awareness/Pages/default.aspx
27.↵
1. Alaqel MA,
2. Alshammari SA,
3. Alahmari SM,
4. Alkhayal NK,
5. Bin Traiki TA,
6. Alhassan NS, et al.
Community knowledge and awareness of colorectal cancer and screening tools: community-based survey of 1,912 residents of Riyadh. Ann Med Surg (Lond) 2021; 72: 103046.
OpenUrl
28.↵
1. Riegert M,
2. Nandwani M,
3. Thul B,
4. Chiu AC,
5. Mathews SC,
6. Khashab MA, et al.
Experience of nurse practitioners carrying out colonoscopy after endoscopic training in more than 1,000 patients. Endosc Int Open 2020; 8: E1423–E1428.
OpenUrl CrossRef PubMed
29.↵
1. Alshammari SA,
2. Alenazi HA,
3. Alshammari HS. Knowledge
, attitude and practice towards early screening of colorectal cancer in Riyadh. J Family Med Prim Care 2020; 9: 2273–2280.
OpenUrl
30.↵
1. Zheng S,
2. Schrijvers JJA,
3. Greuter MJW,
4. Kats-Ugurlu G,
5. Lu W,
6. de Bock GH
. Effectiveness of colorectal cancer (CRC) screening on all-cause and CRC-specific mortality reduction: a systematic review and meta-analysis. Cancers (Basel) 2023; 15: 1948.
OpenUrl
31.↵
1. Babela R,
2. Orsagh A,
3. Ricova J,
4. Lansdorp-Vogelaar I,
5. Csanadi M,
6. De Koning H, et al.
Cost-effectiveness of colorectal cancer screening in Slovakia. Eur J Cancer Prev 2022; 31: 415–421.
OpenUrl
32.↵
1. Edwardson N,
2. Bolin JN,
3. McClellan DA,
4. Nash PP,
5. Helduser JW
. The cost-effectiveness of training US primary care physicians to carry out colorectal cancer screening in family medicine residency programs. Prev Med 2016; 85: 98–105.
OpenUrl
33.↵
1. Haga H,
2. Tran E,
3. Rieger N
. Colonoscopy quality of GP endoscopists in 3 rural hospitals in Queensland, Australia. Aust J Gen Pract 2022; 51: 979–985.
OpenUrl

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Keywords

[1] 1.↵
Bray F,
Laversanne M,
Weiderpass E,
Soerjomataram I
. The ever-increasing importance of cancer as a leading cause of premature death worldwide. Cancer 2021; 127: 3029–3030.
OpenUrl CrossRef PubMed

[2] Bray F,

[3] Laversanne M,

[4] Weiderpass E,

[5] Soerjomataram I

[6] 2.↵
Xi Y,
Xu P
. Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol 2021; 14: 101174.
OpenUrl CrossRef PubMed

[7] Xi Y,

[8] Xu P

[9] 3.↵
Sung H,
Ferlay J,
Siegel RL,
Laversanne M,
Soerjomataram I,
Jemal A, et al.
Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71: 209–249.
OpenUrl CrossRef PubMed

[10] Sung H,

[11] Ferlay J,

[12] Siegel RL,

[13] Laversanne M,

[14] Soerjomataram I,

[15] Jemal A, et al.

[16] 4.↵
Alqahtani MZ,
Mohammed AG,
Alsamghan AS,
Bharti RK,
Alsharm AA,
Alshahrani MT, et al.
Risk factors of colorectal cancer among Saudi population: case-control study. J Family Med Prim Care 2020; 9: 5035–5040.
OpenUrl

[17] Alqahtani MZ,

[18] Mohammed AG,

[19] Alsamghan AS,

[20] Bharti RK,

[21] Alsharm AA,

[22] Alshahrani MT, et al.

[23] 5.↵
Almatroudi A
. The incidence rate of colorectal cancer in Saudi Arabia: an observational descriptive epidemiological analysis. Int J Gen Med 2020; 13: 977–990.
OpenUrl CrossRef PubMed

[24] Almatroudi A

[25] 6.↵
Gupta S
. Screening for colorectal cancer. Hematol Oncol Clin North Am 2022; 36: 393–414.
OpenUrl

[26] Gupta S

[27] 7.↵
Bretthauer M,
Løberg M,
Wieszczy P,
Kalager M,
Emilsson L,
Garborg K, et al.
Effect of colonoscopy screening on risks of colorectal cancer and related death. N Engl J Med 2022; 387: 1547–1556.
OpenUrl CrossRef PubMed

[28] Bretthauer M,

[29] Løberg M,

[30] Wieszczy P,

[31] Kalager M,

[32] Emilsson L,

[33] Garborg K, et al.

[34] 8.↵
Stewart DB
. Updated USPSTF guidelines for colorectal cancer screening: the earlier the better. JAMA Surg 2021; 156: 708–709.
OpenUrl

[35] Stewart DB

[36] 9.↵
Latos W,
Aebisher D,
Latos M,
Krupka-Olek M,
Dynarowicz K,
Chodurek E, et al.
Colonoscopy: preparation and potential complications. Diagnostics (Basel) 2022; 12: 747.
OpenUrl

[37] Latos W,

[38] Aebisher D,

[39] Latos M,

[40] Krupka-Olek M,

[41] Dynarowicz K,

[42] Chodurek E, et al.

[43] 10.↵
Kanth P,
Inadomi JM
. Screening and prevention of colorectal cancer. BMJ 2021; 374: n1855.
OpenUrl Abstract/FREE Full Text

[44] Kanth P,

[45] Inadomi JM

[46] 11.↵
Montminy EM,
Karlitz JJ,
Landreneau SW
. Progress of colorectal cancer screening in United States: past achievements and future challenges. Prev Med 2019; 120: 78–84.
OpenUrl CrossRef PubMed

[47] Montminy EM,

[48] Karlitz JJ,

[49] Landreneau SW

[50] 12.↵
Safiri S,
Sepanlou SG,
Ikuta KS,
Bisignano C,
Salimzadeh H,
Delavari A, et al.
The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol 2019; 4: 913–933.
OpenUrl

[51] Safiri S,

[52] Sepanlou SG,

[53] Ikuta KS,

[54] Bisignano C,

[55] Salimzadeh H,

[56] Delavari A, et al.

[57] 13.↵
Ali Asgari A,
Sazgarnejad S,
Haghdoost B,
Ghasemi Tirtashi M,
Sadeghi A,
Malekzadeh R
. Colonoscopy complications in an Iranian teaching hospital. Middle East J Dig Dis 2022; 14: 51–56.
OpenUrl

[58] Ali Asgari A,

[59] Sazgarnejad S,

[60] Haghdoost B,

[61] Ghasemi Tirtashi M,

[62] Sadeghi A,

[63] Malekzadeh R

[64] 14.↵
Zullo A,
Manta R,
De Francesco V,
Fiorini G,
Hassan C,
Vaira D
. Diagnostic yield of upper endoscopy according to appropriateness: a systematic review. Dig Liver Dis 2019; 51: 335–339.
OpenUrl

[65] Zullo A,

[66] Manta R,

[67] De Francesco V,

[68] Fiorini G,

[69] Hassan C,

[70] Vaira D

[71] 15.↵
Frazzoni L,
La Marca M,
Radaelli F,
Spada C,
Laterza L,
Zagari RM, et al.
Systematic review with meta-analysis: the appropriateness of colonoscopy increases the probability of relevant findings and cancer while reducing unnecessary exams. Aliment Pharmacol Ther 2021; 53: 22–32.
OpenUrl PubMed

[72] Frazzoni L,

[73] La Marca M,

[74] Radaelli F,

[75] Spada C,

[76] Laterza L,

[77] Zagari RM, et al.

[78] 16.↵
Li N,
Lu B,
Luo C,
Cai J,
Lu M,
Zhang Y, et al.
Incidence, mortality, survival, risk factor and screening of colorectal cancer: a comparison among China, Europe, and northern America. Cancer Lett 2021; 522: 255–268.
OpenUrl

[79] Li N,

[80] Lu B,

[81] Luo C,

[82] Cai J,

[83] Lu M,

[84] Zhang Y, et al.

[85] 17.↵
Kerrison RS,
Sheik-Mohamud D,
McBride E,
Whitaker KL,
Rees C,
Duffy S, et al.
Patient barriers and facilitators of colonoscopy use: a rapid systematic review and thematic synthesis of the qualitative literature. Prev Med 2021; 145: 106413.
OpenUrl

[86] Kerrison RS,

[87] Sheik-Mohamud D,

[88] McBride E,

[89] Whitaker KL,

[90] Rees C,

[91] Duffy S, et al.

[92] 18.↵
The American Society for Gastrointestinal Endoscopy. ASGE guidelines. [Updated 2023; accessed 2023 Jan 23]. Available from: https://www.asge.org/home/resources/key-resources/guidelines#newly-published

[93] 19.↵
Makhlouf NA,
Abdel-Gawad M,
Mahros AM,
Lashen SA,
Zaghloul M,
Eliwa A, et al.
Colorectal cancer in Arab world: a systematic review. World J Gastrointest Oncol 2021; 13: 1791–1798.
OpenUrl

[94] Makhlouf NA,

[95] Abdel-Gawad M,

[96] Mahros AM,

[97] Lashen SA,

[98] Zaghloul M,

[99] Eliwa A, et al.

[100] 20.↵
Alyabsi M,
Algarni M,
Alshammari K
. Trends in colorectal cancer incidence rates in Saudi Arabia (2001-2016) using Saudi National Registry: early- versus late-onset disease. Front Oncol 2021; 11: 730689.
OpenUrl CrossRef PubMed

[101] Alyabsi M,

[102] Algarni M,

[103] Alshammari K

[104] 21.↵
Jabar MF,
Halim ME,
Gul YA
. Appropriateness of colonoscopy in a tertiary referral centre. Asian J Surg 2004; 27: 26–31.
OpenUrl PubMed

[105] Jabar MF,

[106] Halim ME,

[107] Gul YA

[108] 22.↵
O’Sullivan JW,
Albasri A,
Nicholson BD,
Perera R,
Aronson JK,
Roberts N, et al.
Overtesting and undertesting in primary care: a systematic review and meta-analysis. BMJ Open 2018; 8: e018557.
OpenUrl Abstract/FREE Full Text

[109] O’Sullivan JW,

[110] Albasri A,

[111] Nicholson BD,

[112] Perera R,

[113] Aronson JK,

[114] Roberts N, et al.

[115] 23.
Odeghe EA,
Oluyemi AO,
Adeniyi OF
. Appropriate use of colonoscopy in Nigeria: a retrospective study using the American Society for Gastrointestinal Endoscopy (ASGE) 2012 guidelines. PAMJ - One Health 2020; 2.

[116] Odeghe EA,

[117] Oluyemi AO,

[118] Adeniyi OF

[119] 24.↵
Kapila N,
Singh H,
Kandragunta K,
Castro FJ
. Open access colonoscopy for colorectal cancer prevention: an evaluation of appropriateness and quality. Dig Dis Sci 2019; 64: 2798–2805.
OpenUrl

[120] Kapila N,

[121] Singh H,

[122] Kandragunta K,

[123] Castro FJ

[124] 25.↵
International Agency for Research on Cancer, World Health Organization. Saudi Arabia - global cancer observatory. [Updated 2020; accessed 2023 Aug 1]. Available from: https://gco.iarc.fr/today/data/factsheets/populations/682-saudi-arabia-fact-sheets.pdf

[125] 26.↵
Ministry Of Health. Colorectal cancer early detection. [Updated 2021; accessed 2023 Aug 1]. Available from: https://moh.gov.sa/en/Ministry/Projects/Colorectal-Cancer-Awareness/Pages/default.aspx

[126] 27.↵
Alaqel MA,
Alshammari SA,
Alahmari SM,
Alkhayal NK,
Bin Traiki TA,
Alhassan NS, et al.
Community knowledge and awareness of colorectal cancer and screening tools: community-based survey of 1,912 residents of Riyadh. Ann Med Surg (Lond) 2021; 72: 103046.
OpenUrl

[127] Alaqel MA,

[128] Alshammari SA,

[129] Alahmari SM,

[130] Alkhayal NK,

[131] Bin Traiki TA,

[132] Alhassan NS, et al.

[133] 28.↵
Riegert M,
Nandwani M,
Thul B,
Chiu AC,
Mathews SC,
Khashab MA, et al.
Experience of nurse practitioners carrying out colonoscopy after endoscopic training in more than 1,000 patients. Endosc Int Open 2020; 8: E1423–E1428.
OpenUrl CrossRef PubMed

[134] Riegert M,

[135] Nandwani M,

[136] Thul B,

[137] Chiu AC,

[138] Mathews SC,

[139] Khashab MA, et al.

[140] 29.↵
Alshammari SA,
Alenazi HA,
Alshammari HS. Knowledge
, attitude and practice towards early screening of colorectal cancer in Riyadh. J Family Med Prim Care 2020; 9: 2273–2280.
OpenUrl

[141] Alshammari SA,

[142] Alenazi HA,

[143] Alshammari HS. Knowledge

[144] 30.↵
Zheng S,
Schrijvers JJA,
Greuter MJW,
Kats-Ugurlu G,
Lu W,
de Bock GH
. Effectiveness of colorectal cancer (CRC) screening on all-cause and CRC-specific mortality reduction: a systematic review and meta-analysis. Cancers (Basel) 2023; 15: 1948.
OpenUrl

[145] Zheng S,

[146] Schrijvers JJA,

[147] Greuter MJW,

[148] Kats-Ugurlu G,

[149] Lu W,

[150] de Bock GH

[151] 31.↵
Babela R,
Orsagh A,
Ricova J,
Lansdorp-Vogelaar I,
Csanadi M,
De Koning H, et al.
Cost-effectiveness of colorectal cancer screening in Slovakia. Eur J Cancer Prev 2022; 31: 415–421.
OpenUrl

[152] Babela R,

[153] Orsagh A,

[154] Ricova J,

[155] Lansdorp-Vogelaar I,

[156] Csanadi M,

[157] De Koning H, et al.

[158] 32.↵
Edwardson N,
Bolin JN,
McClellan DA,
Nash PP,
Helduser JW
. The cost-effectiveness of training US primary care physicians to carry out colorectal cancer screening in family medicine residency programs. Prev Med 2016; 85: 98–105.
OpenUrl

[159] Edwardson N,

[160] Bolin JN,

[161] McClellan DA,

[162] Nash PP,

[163] Helduser JW

[164] 33.↵
Haga H,
Tran E,
Rieger N
. Colonoscopy quality of GP endoscopists in 3 rural hospitals in Queensland, Australia. Aust J Gen Pract 2022; 51: 979–985.
OpenUrl

[165] Haga H,

[166] Tran E,

[167] Rieger N

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Outcomes and appropriateness of colonoscopy referrals at King Khalid University Hospital, Saudi Arabia

An opportunity to expand the colonoscopy screening

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Outcomes and appropriateness of colonoscopy referrals at King Khalid University Hospital, Saudi Arabia

An opportunity to expand the colonoscopy screening

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