Theodore R. Levin’s research while affiliated with Kaiser Permanente and other places

... Special attention should be given to individuals at risk of inadequate bowel preparation, such as the elderly, patients with diabetes or cerebrovascular disease, and hospitalized individuals [57,58]. Both the U.S. Multi-Society Task Force guidelines and the ESGE recommend maintaining adequate bowel preparation in at least 90% of all procedures [59,60] Cecal intubation serves as an indicator not only for observing the right colon but also as a measure of the endoscopist's technical ability to achieve complete insertion. Failure to intubate the cecum indicates an incomplete examination of the entire colon, increasing the likelihood of missed lesions and thus correlating with PCCRC risk. ...

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Post-colonoscopy Colorectal Cancer: Causes and Prevention

... Improving colonoscopy performance is vital to mitigate the threat of CRC and its associated costs. Colonoscopy performance is assessed through multiple quality indicators, among which the adenoma detection rate (ADR) is the most relevant as it is directly associated with the morbidity and mortality of interval CRC [5]. This parameter measures the rate of precancerous lesions that are identified and removed during a colonoscopy procedure. ...

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A Novel Assistive Imaging Device for Colon Map Reconstruction

... Randomized controlled trials (RCTs) have shown screening with guaiac-based fecal occult blood test (gFOBT), sigmoidoscopy, or colonoscopy to be effective at reducing CRC risk and mortality [3][4][5][6]. There is now observational study evidence that fecal immunochemical test (FIT) is effective at reducing mortality risk [7][8][9][10]. Analysis of the results of population-based screening programs report reductions of CRC incidence, mortality, and surgery rates [10,11]. ...

Reference:

FIT as a Comparator for Evaluating the Effectiveness of New Non-invasive CRC Screening Test

... Hepatocellular carcinoma (HCC) represents the most common primary liver tumor and is the third leading cause of cancer-related deaths worldwide [1] . It is expected that the number of new cases of HCC will increase by 55% in the next two decades, representing a major public health issue [2] . The majority of HCC arises from a background of chronic liver disease and cirrhosis, and it is associated with risk factors such as viral hepatitis, alcohol consumption, and metabolic syndrome. ...

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The application of artificial intelligence-based tools in the management of hepatocellular carcinoma: current status and future perspectives

... Despite the solid evidence that screening can decrease colorectal cancer (CRC) incidence and CRC mortality [1,2] and the availability of multiple screening test options with a range of attributes [3], screening for CRC and its precursors remains underutilized around the world among persons who are eligible for screening. Research and development of novel tests to screen for CRC and its precursors is a dynamic field [4][5][6][7][8], fueled by the goals to improve the sensitivity and specificity of available tests, and to address patient concerns over the attributes of existing tests (e.g., the stool handling that is required by fecal test-based strategies or the invasive nature of colonoscopy and the required colon cleansing before colonoscopy) and by the commercial opportunities for industry in the large CRC screening market. From the public health perspective, novel tests should ideally deliver improved outcomes at acceptable incremental costs and ease of use. ...

Reference:

Modeling and the Use of Surrogate Endpoints: Is This a Valid Approach?

... This refers to the provision of necessary health services and information to communities that might not otherwise have access. An organized, population-based outreach has been shown to increase CRC screening participation rates and adherence in diverse and underserved patient populations (129,130). This entails large-scale cooperation and multicomponent interventions at the level of the government, the health system, the provider, and the patient population. ...

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Colorectal cancer: local results and significance in Hungary

... Colonoscopy, the most common screening test for colorectal cancer (CRC), is associated with reduced CRC incidence and mortality through early detection and treatment of cancer [1]. Adenomas are found in nearly 40% of screening colonoscopies in the US, and after their removal, patients undergo future surveillance. ...

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Prevalence of Abnormalities at Tandem Endoscopy in Patients Referred for Colorectal Cancer Screening/Surveillance Colonoscopy

... "Development and external validation of a prediction model for colorectal cancer among patients awaiting surveillance colonoscopy following polypectomy", where adenoma detection rate (ADR) was a seminal performance measure. 1 Incidentally, another recent paper Su-Ying Liang et al, 2 showed seminal findings that both ADR and sessile serrated lesion detection rate were initially reduced in older (surmised by: "years in practice") male endoscopists, the differences lessening over time. Although improvements were noted in this group, other factors may affect older endoscopists as the brief case report below shows, in the sensitive interval between 2 cataract surgeries, performed serially. ...

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Decline in a colonoscopist’s ADR after first cataract surgery with restoration after second cataract surgery

... These blood-based tests often have relatively high-cost and are unlikely to be cost-effective as first line screening tests in their initial iterations [37]. Nevertheless, as non-invasive fecal and bloodbased tests continue to emerge and improve performance, it's reasonable to ask whether screening colonoscopy, which is invasive and risky compared to fecal and blood tests, has a future for CRC screening in the US [38]. The answer to this question will always depend on the details of specific non-invasive tests, including sensitivity for cancer, advanced adenomas, serrated lesions, test cost, and test specificity [39]. ...

Reference:

Colonoscopy Remains an Important Option for Primary Screening for Colorectal Cancer

... The recently published update to the World Endoscopy Organization (WEO) CRC Screening Committee Expert Working Group (EWG) guiding principles on the evaluation of novel non-invasive screening tests proposes a four-phased approach and considers where decision analytic modeling may be useful [9]. Phases I and II consist, respectively, of small studies assessing the test's ability to discriminate between CRC and non-cancer states and the test's accuracy across the continuum of neoplastic lesions in neoplasiaenriched populations. ...

Reference:

Modeling and the Use of Surrogate Endpoints: Is This a Valid Approach?