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Prevention
Vitamin D intake and circulating blood levels are associated with a lower risk of colon cancer.[81][82] However, current guidelines for the amount of circulating vitamin D required to minimize risk remains inconclusive.[1] A study has shown that the optimal levels required to reduce colorectal cancer risk is higher than current recommendations set out by the Institute of Medicine (US).[1]
Screening
Fecal occult blood testing (FOBT) of the stool is typically recommended every two years and can be either guaiac-based (gFOBT) or immunochemical (iFOBT).[18] If abnormal FOBT results are found, participants are typically referred for a follow-up colonoscopy examination. Yearly to every two year FOBT screening reduces colorectal cancer deaths by 16% and among those participating in screening colorectal cancer deaths can be reduced up to 23%, although it has not been proven to reduce all-cause mortality.[90] iFOBT testing has shown superior sensitivity and specificity compared to gFOBT.[2] In addition, it has a low cost relative to most other screening procedures and it’s becoming the new standard screening tool for average risk patients in most countries.[2] iFOBT looks for biomarkers associated with colorectal cancer and precancerous lesions, including altered DNA and blood hemoglobin. An advantage of iFOBT is that it doesnot require dietary or medication changes before testing.[91] However,FIT-DNA has more false positives than FIT and thus results in more adverse effects.[5] Further study is required as of 2016 to determine if a three year screening interval is correct.[5]
Another screening option is a virtual colonoscopy.[87] Virtual colonoscopy via a CT scan appears as good as standard colonoscopy for detecting cancers and large adenomas but is expensive, associated with radiation exposure, and cannot remove any detected abnormal growths like standard colonoscopy can.[18]
- references
- ^ a b McCullough, M.L., Zoltick, E.S., Weinstein, S.J., Fedirko, V., Wang, M., Cook, N.R., … Smith-Warner, S.A. (2018). Circulating vitamin D and colorectal cancer risk: An international pooling project of 17 cohorts. Journal of the National Cancer Institute, djy087.
- ^ a b Zhang, J., Cheng, Z., Ma, Y., He, C., Lu, Y., Zhao, Y., … Cheng, N. (2017). Effectiveness of screening modalities in colorectal cancer: A network meta-analysis. Clinical colorectal cancer, 16(4), 252-63.
comments
edit- The new source for the vitamin D is a primary source. This is not OK per WP:MEDRS. The two refs cited from the article are from 2011 which are old per WP:MEDDATE. Can you find a MEDRS sources for this vitamin D stuff and update the whole bit?
- You use the term "current" in the vitamin D section and in the screening section you say "is becoming the new standard..." Wikipedia articles have no dates, and we avoid writing like that per WP:RELTIME. Please fix those things
- the citations for the 2 refs are not formatted properly. Please see WP:MEDHOW
- In the screening section, again you are incorporating old, existing refs (the lancet ref from 2010). It would be good to update all the refs.
- In the screening section I didn't find that the proposed content "it’s becoming the new standard screening tool for average risk patients in most countries." is supported by the Zhang reference. Where is that, in the source?
- no where does it say that the fecal blood test has ok sensitivity but low specificity generally, and it is kind of weird to go into the details of sensitivity/specificity among FOB methods without that general statement. Jytdog (talk) 00:06, 7 November 2018 (UTC)
Thanks for sharing your proposed article improvements @KawaiiLeonard:I agree with the above comment about your first reference. If you have any questions about this, please let me know, I am happy to help. Since this is such a recent study, it may be difficult to find a high quality secondary source that reviews this study. Do you have an other ideas of references to use here to support your guideline statement? If there is nothing that meets Wikipedia:Identifying reliable sources (medicine) available yet, we will have to wait until the study you found is summarized to share it on WP.
Can you try to make this text easier for someone who is not in the medical background understand? You can try to re-word this sentence: "In addition, it has a low cost relative to most other screening procedures and it’s becoming the new standard screening tool for average risk patients in most countries". Please replace the use of "patients" with people (as per MEDMOS- Wikipedia:Manual of Style/Medicine-related articles#Common pitfalls). Thank you again for working on this article. Your group is doing a good job! JenOttawa (talk) 18:03, 7 November 2018 (UTC)