Colon Cancer Screening Centre Research Articles

Development and validation of a risk prediction model for high-risk adenomas at the time of first screening colonoscopy among screening aged Canadians

The aim of this study was to develop a risk prediction model for high risk adenomas (HRAs) detected at screening colonoscopy based on readily available participant information. The cohort consisted of 3035 participants aged 50 to 74 years with no history of cancer who underwent a primary screening colonoscopy at a centralized colon cancer screening centre between 2008 and 2016. A multivariable logistic regression model was created using CRC risk factors identified from prior research. Model covariates were collected from a baseline questionnaire and included participant demographics (age and sex), lifestyle parameters (body mass index, alcohol, smoking, and vitamin D supplement use) and medical history (family history of CRC and diabetes). Mean participant age was 58.8 years, and 54.7% were male. 249 participants with HRAs were identified (8.2%). An adjusted c-statistic of 0.67 was calculated, and a specificity and negative predictive value of 97.2% (95% CI: 96.5–97.8) and 92.5% (95% CI: 92.2–92.8) for the detection of HRAs, respectively, were achieved using 20% predicted probability as a high-risk threshold. However, only a sensitivity of 12.1% (95% CI: 8.3–16.8) was achieved. Our model has moderate predictive ability, with strengths in being able to rule out those with an absence of HRAs on screening colonoscopy. Maximizing screening efficiency through improved risk prediction can enhance resource allocation. Ultimately, this model has the potential to improve patient care by reducing unnecessary colonoscopies, limiting this invasive procedure to those most likely to have significant findings.

Cohort profile: The Forzani & MacPhail Colon Cancer Screening Centre biorepository, Calgary, Alberta

PurposeThe Colon Cancer Screening Centre (CCSC) biorepository (Calgary, Canada) supports a wide range of research topics related to colorectal cancer (CRC) by collecting, and storing biospecimens (blood, urine, normal colon...

Development of a definition and rules for causal attribution of post-colonoscopy bleeding.

Post-colonoscopy bleeding (PCB) is an important colonoscopy quality indicator that is recommended to be routinely collected by colorectal cancer screening programs and endoscopy quality improvement programs. We created a standardized and reliable definition of PCB and set of rules for attributing the relatedness of PCB to a colonoscopy. PCB events were identified from colonoscopies performed at the Forzani & MacPhail Colon Cancer Screening Centre. Existing definitions and relatedness rules for PCB were reviewed by the authors and a draft definition and set of rules was created. The definition and rules were revised after initial testing was performed using a set of 15 bleeding events. Information available for each event included the original endoscopy report and data abstracted from the emergency or inpatient record by a trained research assistant. A validation set of 32 bleeding events were then reviewed to assess their interrater reliability by having three endoscopists and one research assistant complete independent reviews and three endoscopists complete a consensus review. The Kappa statistic was used to measure interrater reliability. The panel classified 28 of 32 events as meeting the definition of PCB and rated 7, 8 and 6 events as definitely, probably and possibly related to the colonoscopy, respectively. The Kappa for the definition of PCB for the three independent reviews was 0.82 (substantial agreement). The Kappa for the attribution of the PCB to the colonoscopy by the three endosocopists was 0.74 (substantial agreement). The research assistant had a high agreement with the panel for both the definition (100% agreement) and application of the causal criteria (kappa 0.95). A standardized definition of PCB and attribution rules achieved high interrater reliability by endoscopists and a non-endoscopist and provides a template of required data for event adjudication by screening and quality improvement programs.

Vitamin D supplementation reduces the occurrence of colorectal polyps in high-latitude locations

There is suggestive evidence for the role of vitamin D in the development of colorectal cancer (CRC). Due to high latitudes in Canada, many Canadians are vitamin D deficient throughout winter. In this analysis, we examined the association between vitamin D supplement use and high-risk adenomatous polyps (HRAPs). The study population was drawn from the biorepository at the Forzani & MacPhail Colon Cancer Screening Centre (CCSC) in Calgary. Individuals enrolled between 2013 and 2016 between the age of 50 and 74 years (n = 1409) were included. When examining the association between any supplemental vitamin D use and HRAPs, a protective effect is observed with an ORadj of 0.57 (95% CI: 0.33–0.96). Similarly, meeting the recommended daily intake (RDI) of vitamin D (600 IU) is protective against HRAPs with an ORadj of 0.78 (95% CI: 0.62–0.99). This study suggests that adequate vitamin D supplementation reduces the occurrence of colorectal polyps in high-latitude locations.

A20 VITAMIN D SUPPLEMENTATION REDUCES THE OCCURRENCE OF COLORECTAL POLYPS IN HIGH-LATITUDE LOCATIONS

Abstract Background There is suggestive evidence for the role of vitamin D in the development of colorectal cancer (CRC). Furthermore, previous studies have observed associations with vitamin D supplementation and lower incidence of CRC. Due to high latitudes in Canada, many Canadians are vitamin D deficient throughout winter Aims In this analysis, we aimed to examine the association between either vitamin D supplement use or meeting the reccommended daily intake of vitamin D, and either any colorectal polyp, or a known precursor of CRC: high-risk adenomatous polyps (HRAPs). Methods The study population was drawn from the biorepository at the Forzani & MacPhail Colon Cancer Screening Centre (CCSC) in Calgary. Data were obtained from the Diet History Questionnaire (DHQ) I or II, the Health and Lifestyle Questionnaire (HLQ), and through post-colonoscopy reports completed by the endoscopist. Multivariable logistic regression models were used to examine the association between intake of supplemental vitamin D and presence of HRAPs. Models were adjusted for age, sex, BMI, fiber intake, alcohol consumption, and smoking status. Results Individuals between the age of 50 and 74 years (n= 1,409) were included. When examining the association between any supplemental vitamin D use and HRAPs, a protective effect was observed with an ORadj of 0.57 (95% CI: 0.33–0.96). Similarly, meeting the recommended daily intake (RDI) of vitamin D (600 IU) was protective against HRAPs with an ORadj of 0.78 (95% CI: 0.62–0.99). Conclusions This study suggests that adequate vitamin D supplementation can reduce the risk of HRAPs. These results could be used to inform public health recommendations for vitamin D intake with hopes of reducing the risk of HRAPs. Funding Agencies None

A randomized clinical prospective trial comparing split-dose picosulfate/ magnesium citrate and polyethylene glycol for colonoscopy preparation.

BackgroundColonoscopy remains the gold standard for the investigation of abnormalities within the colon. However, its success is highly dependent on the quality of bowel preparation. The objective of this study was to compare the bowel preparation efficacy of picosulfate/magnesium citrate (PMC) vs polyethylene glycol (PEG) in a one-day vs two-day split dose regimen.MethodsA prospective, randomized, controlled trial was conducted at the Forzani & MacPhail Colon Cancer Screening Centre in Calgary, Canada. 171 colonoscopy outpatients were randomized to split-dose PMC or PEG lavage as well as into one-day split or two-day split regimens in blocks of eight. Bowel preparation quality was recorded in a blinded manner by the endoscopist using the Ottawa Bowel Preparation Scale (OBPS) prior to washing or suctioning. The scale results were analyzed using a two-factor analysis of variance.Results141 patients received complete colonoscopies (PMC-71; PEG-70). PEG was found to be superior to PMC (mean OBPS: 4.14 ± 2.64 vs 5.11 ± 3.44, p = 0.019), when adjusted for administration regimen, leading to significantly more adequate bowel preparations (79.7% vs 59.7%, p = 0.007). A two-day split dose was superior to a one-day split dose regimen (mean OBPS: 3.68± 2.82 vs 5.69 ± 3.06, p<0.001). Two-day split dosing also resulted in a better right colon cleanliness score (right bowel OBPS 1.27±0.11 vs 2.10±0.12 for one-day split, P<0.001).ConclusionsOptimal bowel preparation was achieved with the use of PEG lavage when administered in a two-day split dose regimen. This trial is registered with ClinicalTrials.gov under identifier NCT01415687.

Linking lab, program, and administrative data to provide comprehensive colorectal cancer screening status of patients to primary care providers in Calgary, Alberta

IntroductionColorectal cancer (CRC) screening is associated with significant reductions in burden, mortality and cost. Primary care providers in Alberta do not have access to integrated CRC testing histories for patients. Providing this information will support CRC screening among patients at average and high risk, follow-up of abnormal tests, and surveillance.&#x0D; Objectives and ApproachCalgary Laboratory Services, Colon Cancer Screening Centre, Alberta Cancer Registry, and endoscopy data were linked to create a comprehensive CRC screening history at the patient level. Based on screening histories and the current Clinical Practice Guideline, an algorithm was created to determine CRC screening statuses with the aim of providing accurate screening rates when linked to primary care provider patient panels. Results from the linkage are designed to be incorporated into clinic and EMR workflow processes to support adherence to evidence-based screening recommendations at the point of care.&#x0D; ResultsA comprehensive assessment of screening status was determined by integrating Fecal Immunochemical Test (FIT) and colonoscopy data. Among a sample cohort, patients were identified as being due for screening with FIT, requiring follow-up for a positive FIT test, or requiring appropriate surveillance for a positive-screen or abnormal colonoscopy findings. A summary report, actionable list, and resources were developed to convey findings. The summary report displayed CRC screening rates for a provider’s panel. The actionable list provided CRC screening statuses for each patient aged 40 to 84 indicating patients due for screening with FIT, for follow-up of positive FIT, or for surveillance colonoscopy. The resources were developed to support quality improvement for colorectal cancer screening for patients.&#x0D; Conclusion/ImplicationsThe data linkages and algorithm provide comprehensive CRC screening, follow-up, and surveillance information that could support guideline-adherent screening, increase screening rates, reduce duplication or unnecessary testing, and provide primary care providers with timely and robust information to support clinical decisions for individuals inside and outside of the target screening population.

Abstract 2213: A simple risk prediction model for high-risk adenomatous polyps at the time of colonoscopy

Abstract Introduction: The prediction of high risk adenoma polyp (HRAP) may help to prioritize the urgency and guide the performance of colonoscopy procedures. Our objective was to develop and internally validate a simple, scalable clinical prediction model. Methods: The study population consisted of 2,364 individuals aged 50 to 74 with no prior history of cancer who had a screening colonoscopy at the Forzani and MacPhail Colon Cancer Screening Centre in Calgary, Canada. A total of 190 HRAPs were identified (8.0%). A multivariable logistic regression model was created using colorectal cancer risk factors identified from prior research. Predictor variables were collected from a baseline health questionnaire and included patient demographic (age, sex, and ethnicity), lifestyle (body mass index, alcohol (daily vs. no), smoking (never vs. ever), physical activity (high vs. moderate to low), and non-steroidal anti-inflammatory drug (NSAID) use (yes vs. no)), medical (family history of colorectal cancer, personal history of diabetes, or fecal occult blood test within the past two years), and female-specific characteristics (menopausal status and hormone replacement therapy (yes vs. no)). The demographic variables were first used to create a baseline model and the benefits of adding the groups of lifestyle, medical, and female-specific variables into the model in various combinations was assessed. Five-fold internal cross validation was conducted. Performance was assessed using the C-statistic and Hosmer-Lemeshow goodness-of-fit test. Results: The average age of the participants was 58 years of whom 54.9% were male and 85.24% were Caucasian. The clinical prediction model included demographic and lifestyle variables. On average, the predicted probability of having a HRAP was 8.0% (IQR: 4.1% to 10.6%). The bias-adjusted C-statistic was 0.66 (95% CI: 0.62 to 0.70) and there was no evidence of a lack of calibration according to the Hosmer-Lemeshow goodness-of-fit test. The addition of the medical history variables (Δ AUC = +0.0001; p = 0.98) or female-specific variables (Δ AUC = + 0.006; p = 0.32) or both medical and female-specific groups of variables (Δ AUC = +0.004; p = 0.45) did not significantly improve predictive performance. Conclusions: A model based on demographic and lifestyle variables showed a modest predictive ability for having an HRAP at the time of colonoscopy in a population undergoing screening-related colonoscopies. Consideration of these factors may assist in guiding prioritization of limited screening resources. Next steps include external validation and testing the incremental predictive ability of circulating biomarkers. Citation Format: Devon J. Boyne, Lisa M. Lix, Susanna Town, Steven J. Heitman, Robert J. Hilsden, Darren R. Brenner. A simple risk prediction model for high-risk adenomatous polyps at the time of colonoscopy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2213.

Abstract B02: Recreational physical activity, sedentary time and the incidence of colorectal polyps in a screening population for colon cancer

Abstract Background: Despite the consistent association between regular recreational moderate to vigorous physical activity (rMVPA) and reduced risk of colorectal cancer (CRC), few studies have examined the effect of physical activity on carcinogenic development by examining colorectal adenomas (polyps). Furthermore, even fewer studies have examined the impact of sedentary behavior/time (ST) on the development of polyps. In this study we examined the associations between rMVPA and ST and the presence, number and type of colorectal polyps in a population undergoing screening for colorectal cancer in Calgary, Alberta, Canada. Methods: A cross-sectional study of 2,499 individuals undergoing colonoscopy at the Forzani &amp; MacPhail Colon Cancer Screening Centre in Calgary, Canada was conducted. Physical activity levels and ST were characterized using hours of rMVPA, meeting cancer prevention recommendations (≥150 mins/wk of rMVPA) and hours of ST using self-reported data from the Long Form International Physical Activity Questionnaire. Unconditional logistic regression models were used to estimate the crude and adjusted odds ratios (OR) for presence of polyps associated with rMVP and ST. Results: Crude estimates for meeting cancer prevention guidelines (ORunadj=0.83, 95% CI: 0.70-0.98) and increasing rMVPA (ORunadj=0.75, 95% CI: 0.60-0.93 for 1-3 hrs/wk vs. 0) were associated with lower odds of having ≥1 polyp at screening. Effect estimates were attenuated in adjusted models. Threshold effects were observed for ST with significant associations observed for up to 20 hours/week of sitting time (ORadj per hour sitting=1.05, 95% CI: 1.01-1.09). Associations were strongest for rMVPA among females (ORadj=0.68, 95% CI: 0.48-0.97 for 1-3 hrs/wk vs. 0) and for ST among males (ORadj=1.74, 95% CI: 1.06-2.86 for 14-35hrs/wk of ST vs. 0-14 hrs/wk) Conclusions: In this large population undergoing colonoscopy screening for colorectal cancer, rMVPA was associated with reduced prevalence of polyps at screening, particularly among females. Even low amounts of regular ST (2-5hrs/day) were associated with the presence of polyps, particularly among males. Strategies aimed at reducing the amount of pre-carcinogenic colon lesions should combine increasing rMVPA and reducing ST. Citation Format: Darren R. Brenner, Demetra H. Yannitsos, Matthew Warkentin, Eileen Shaw, Nigel T. Brockton, S. Elizabeth McGregor, Susanna Town, Robert J. Hilsden. Recreational physical activity, sedentary time and the incidence of colorectal polyps in a screening population for colon cancer. [abstract]. In: Proceedings of the AACR Special Conference: Improving Cancer Risk Prediction for Prevention and Early Detection; Nov 16-19, 2016; Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(5 Suppl):Abstract nr B02.

Defining Benchmarks for Adenoma Detection Rate and Adenomas Per Colonoscopy in Patients Undergoing Colonoscopy Due to a Positive Fecal Immunochemical Test.

Although there is an accepted benchmark for adenoma detection rate (ADR) in average risk screening colonoscopy, a benchmark for ADR or the associated quality indicator, adenomas per colonoscopy (APC), for colonoscopies performed for a positive fecal immunochemical test (FIT+) has not been established. The purpose of this study was to propose methods for establishing a benchmark ADR and APC for FIT+ patients. In this historical cohort study, we included 15,329 patients aged 50-74 years who underwent a colonoscopy at Alberta Health Services' Colon Cancer Screening Centre, Calgary, Canada, from 1 January 2014 to 30 June 2015 for either investigation of a positive FIT or average risk screening. Using meta-regression, we estimated for FIT+ patients the ADR and APC that corresponded to (Method #1: minimally acceptable) an ADR of 25% in average risk individuals, (Method #2: standard of care) the average ADR or APC in all FIT+ patients, and (Method #3: aspirational) the average FIT+ ADR or APC in colonoscopies performed by endoscopists with an ADR of ≥35% in average risk patients. At least one adenoma was detected in 30% of average risk patients and 58% of FIT+ patients. The calculated benchmark FIT+ ADRs for the three methods were 55, 60, and 65%, respectively. The calculated benchmarks for FIT+ APC were 1.2, 1.4, and 1.7, respectively. To account for expected random variation in individual endoscopists' ADR or APC, we propose using the upper bound of the 95% confidence interval of an endoscopist's ADR or APC to determine if they fall below a given benchmark. We have proposed methods of defining benchmarks for ADR and APC in FIT+ patients that go beyond the current "minimally acceptable" threshold currently recommended in average risk patients. These new thresholds represent results obtained by all peers and by a group of expert adenoma detectors defined in an independent patient cohort (average risk). Because the true adenoma burden in FIT+ patients could vary based on factors such as the threshold used to define a positive FIT, screening programs or endoscopy units may need to calculate their own benchmarks using local data.

Unexpected Hospitalizations and Emergency Room Visits within 30 Days of a Colorectal Cancer Screening-related Colonoscopy Performed at a Canadian Non-hospital Endoscopy Unit

Purpose: To determine the rate of and reasons for unexpected emergency room (ER) and inpatient (IP) stays within 30 days of a colorectal cancer (CRC) screening-related colonoscopy in asymptomatic, generally healthy individuals. Methods: All 24,145 colonoscopy appointments from 2008-2010 at the Forzani and MacPhail Colon Cancer Screening Centre, a publicly-funded non-hospital endoscopy unit, were identified from the endoscopy reporting system Endopro, whether or not the colonoscopy was performed. Patients were ASA I/II, free of significant comorbidities. Colonoscopies were performed by one of 51 gastroenterologists or colorectal surgeons. Patients were linked by their personal health number to provincial administrative databases by Alberta Health Services, the government body responsible for providing all emergency and inpatient care in the province of Alberta. All ER and IP visits (events) from two days prior to 30 days after the scheduled date were identified, and research assistants completed reviews of the hospital chart. Severity of the event was classified using a modification of the NHS Bowel Cancer Screening Programme criteria. Causal relationship to the colonoscopy appointment was established by consensus of three of the authors. Results: A total of 22,253 patients (47% men; mean age 56 years; range 17-75) had at least one appointment. Indications for colonoscopy were screening (89%), CRC/adenoma surveillance (5%) and positive FOBT (5%). Overall, 498 events were identified (2.1% of appointments), of which 337 (67%) were not related, 138 (28%) were definitely related and 23 (5%) were possibly related to the appointment; 84% of related events occurred within seven days of the colonoscopy. Thirty events occurred prior to the appointment date, of which six (21%) were definitely or possibly related to the bowel preparation. 21,518 patients underwent 22,054 colonoscopies. Events definitely or possibly related to the colonoscopy occurred in 146 (0.7%), of which 88 (60%) were ER visits with no associated IP stay. There were seven (0.3/1,000) perforations and four (0.2/1,000) post-polypectomy syndromes. There were no colonoscopy-related deaths. Event severity was mild in 107 (72%), intermediate in 33 (22%), and major in nine (6%). The most common colonoscopyrelated events were bleeding (n=63; rate 2.9/1,000) and gastrointestinal symptoms (45; 2.0/1,000). Conclusion: Approximately 2.1% of patients had an ER visit or unexpected IP admission immediately prior to or within 30 days of a scheduled colonoscopy, but most are unrelated to the colonoscopy. Events resulting from a colonoscopy occurred in 0.7%, with bleeding and GI symptoms as the most common causes. The majority of colonoscopy-related events occurred within seven days of the test.

Fecal Occult Blood Testing While Waiting for Screening Colonoscopy in Average-Risk Individuals: Durable Option or Short-Term Solution?

As the second leading cause of cancer mortality, colorectal cancer (CRC) is an important health issue. CRC fulfills the WHO criteria for mass screening (1). Furthermore, clinical practice guidelines have broadly endorsed CRC screening (2–5) and, for average-risk individuals, have generally supported choice among the available screening options. Nevertheless, CRC screening uptake remains disappointingly low (6). Population-based CRC screening programs are on the rise internationally, including here in Canada where several Canadian provinces either have a screening program in place or in development (7). Programs tend to support primary screening with the fecal occult blood test (FOBT) among those at average risk (7). Indeed, the recent Canadian Association of Gastroenterology position statement has emphasized that fecal immunochemical testing (FIT) or a high-sensitivity guaiac-based FOBT should be used for programmatic average-risk screening, with FIT being the test of choice (4), an approach that is also cost effective (8,9). Nevertheless, the use of colonoscopy for primary CRC screening is on the rise in many jurisdictions, which has contributed to long wait times for colonoscopy. In the current issue of The Canadian Journal of Gastroenterology, McGregor et al (10) (pages 248–252) report on the results of their study aimed to inform the content and design of a mailed invitation for average-risk individuals to complete an FOBT while on the wait list for screening colonoscopy. Focus groups were created through mailed invitation letters sent to 150 average-risk individuals randomly selected from the wait list for screening colonoscopy at the Forzani and MacPhail Colon Cancer Screening Centre in Calgary, Alberta. The purpose of the focus groups was to explore the reactions of average-risk individuals to different materials and strategies designed to encourage the completion of an FOBT while awaiting screening colonoscopy. Thirty-four individuals responded to the invitation, and 28 were ultimately available to attend one of three focus groups. The key findings from the focus groups were as follows: individuals were generally receptive to a mailed FOBT invitation, but the credibility of the materials sent was important and ideally associated with their family physician; brief letters without overuse of medical terminology were preferred; receipt soon after referral for colonoscopy along with a description of how the FOBT results would affect an individual’s position on the waiting list appeared to increase the likelihood of a response; and including the FOBT kit itself along with supportive materials in the mail were considered to be useful. There were limitations to this study that warrant consideration. The sample was comprised primarily of English-speaking, educated Caucasian individuals at a single academic institution. In addition, the number of individuals sampled was small, which may have limited the diversity of the opinions elicited. Finally, the overall response rate was low. As acknowledged by the authors, these factors have important implications in terms of the generalizability of the study findings. Despite its limitations, the study performed by McGregor et al (10) suggests that average-risk individuals would be receptive to an organized CRC screening intervention with FOBT while awaiting colonoscopy. Furthermore, it provides some guidance on how to optimize ‘buy in’ of such an intervention among those facing long wait times for screening colonoscopy. As such, these findings deserve consideration as a wait list management strategy. However, as population-based CRC screening programs become more widespread and established with an accompanying increase in screening uptake, it is inevitable that wait times for colonoscopy will amplify. It is conceivable that average-risk individuals wait-listed for primary screening colonoscopy might only receive the procedure when their stool-based test is positive. As such, a strategy of FOBT while waiting for screening colonoscopy may simply be a short-term solution. Instead, perhaps we should use the findings of McGregor et al (10) to develop an optimized FOBT – or better yet, FIT-based – CRC screening program for average-risk individuals to determine who should be offered a colonoscopy in the first place, rather than as a means of managing an increasingly unmanageable wait list. It may be time to reconsider whether primary screening colonoscopy for the average-risk individual with a negative fecal-based screening test is something we can – or should – be offering, given our current demands and resource constraints.

Development and Implementation of a Comprehensive Quality Assurance Program at a Community Endoscopy Facility

Quality assurance (QA) is a process that includes the systematic evaluation of a service, institution of improvements and ongoing evaluation to ensure that effective changes were made. QA is a fundamental component of any organized colorectal cancer screening program. However, it should play an equally important role in opportunistic screening. Establishing the processes and procedures for a comprehensive QA program can be a daunting proposition for an endoscopy unit. The present article describes the steps taken to establish a QA program at the Forzani & MacPhail Colon Cancer Screening Centre (Calgary, Alberta) - a colorectal cancer screening centre and nonhospital endoscopy unit that is dedicated to providing colorectal cancer screening-related colonoscopies. Lessons drawn from the authors' experience may help others develop their own initiatives. The Global Rating Scale, a quality assessment and improvement tool developed for the gastrointestinal endoscopy services of the United Kingdom's National Health Service, was used as the framework to develop the QA program. QA activities include monitoring the patient experience through surveys, creating endoscopist report cards on colonoscopy performance, tracking and evaluating adverse events and monitoring wait times.

What are the biggest challenges and opportunities for biorepositories in the next three to five years?

Biopreservation and BiobankingVol. 8, No. 2 The Experts SpeakWhat Are the Biggest Challenges and Opportunities for Biorepositories in the Next Three to Five Years?Fay Betsou, David L. Rimm, Peter H. Watson, Christopher Womack, Allison Hubel, Robert A. Coleman, Liz Horn, Sharon F. Terry, Nikolajs Zeps, Brian J. Clark, Lisa B. Miranda, Robert E. Hewitt, and Gloria D. ElliottFay BetsouSearch for more papers by this author, David L. RimmSearch for more papers by this author, Peter H. WatsonSearch for more papers by this author, Christopher WomackSearch for more papers by this author, Allison HubelSearch for more papers by this author, Robert A. ColemanSearch for more papers by this author, Liz HornSearch for more papers by this author, Sharon F. TerrySearch for more papers by this author, Nikolajs ZepsSearch for more papers by this author, Brian J. ClarkSearch for more papers by this author, Lisa B. MirandaSearch for more papers by this author, Robert E. HewittSearch for more papers by this author, and Gloria D. ElliottSearch for more papers by this authorPublished Online:14 Sep 2010https://doi.org/10.1089/bio.2010.8210AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View articleFiguresReferencesRelatedDetailsCited byDevelopment of “Biosearch System” for biobank management and storage of disease associated genetic informationJournal of King Saud University - Science, Vol. 34, No. 2Biobanking for Translational Diabetes Research in India Charitha Gangadharan, Soniya Wills, Rajani Kanth Vangala, and Alben Sigamani19 August 2020 | BioResearch Open Access, Vol. 9, No. 1Cohort profile: The Forzani & MacPhail Colon Cancer Screening Centre biorepository, Calgary, Alberta11 November 2020 | BMJ Open, Vol. 10, No. 11Obstacles to Widening Biosample Research23 October 2017 | Science and Engineering Ethics, Vol. 25, No. 1Biobanking: Objectives, Requirements, and Future Challenges—Experiences from the Munich Vascular Biobank16 February 2019 | Journal of Clinical Medicine, Vol. 8, No. 2Building a ‘Repository of Science’: The importance of integrating biobanks within molecular pathology programmesEuropean Journal of Cancer, Vol. 67The Biobank Economic Modeling Tool (BEMT): Online Financial Planning to Facilitate Biobank Sustainability Hana Odeh, Lisa Miranda, Abhi Rao, Jim Vaught, Howard Greenman, Jeffrey McLean, Daniel Reed, Sarfraz Memon, Benjamin Fombonne, Ping Guan, and Helen M. Moore23 December 2015 | Biopreservation and Biobanking, Vol. 13, No. 6Integration, Networking, and Global Biobanking in the Age of New BiologyHuman biological sample biobanking to support tissue biomarkers in pharmaceutical research and developmentMethods, Vol. 70, No. 1Introducing Research Initiatives into Healthcare: What Do Doctors Think? Lucy Wyld, Sian Smith, Nicholas J. Hawkins, Janet Long, and Robyn L. Ward21 April 2014 | Biopreservation and Biobanking, Vol. 12, No. 2Introduction: The Cardinal Role of Biobanks and Human Biospecimen Collections in Biomarker Validation: Issues Impeding Impact of Biomarker Research OutcomesBeyond ELSIsCurrent Status, Challenges, Policies, and Bioethics of BiobanksGenomics & Informatics, Vol. 11, No. 4Development of a Website and Biobank Database for the Nanosized Cancer Polymarker Biochip Project: A Multicenter Italian Experience13 March 2018 | The International Journal of Biological Markers, Vol. 26, No. 3Biobanking: the foundation of personalized medicineCurrent Opinion in Oncology, Vol. 23, No. 1 Volume 8Issue 2Jun 2010 InformationCopyright 2010, Mary Ann Liebert, Inc.To cite this article:Fay Betsou, David L. Rimm, Peter H. Watson, Christopher Womack, Allison Hubel, Robert A. Coleman, Liz Horn, Sharon F. Terry, Nikolajs Zeps, Brian J. Clark, Lisa B. Miranda, Robert E. Hewitt, and Gloria D. Elliott.What Are the Biggest Challenges and Opportunities for Biorepositories in the Next Three to Five Years?.Biopreservation and Biobanking.Jun 2010.81-88.http://doi.org/10.1089/bio.2010.8210Published in Volume: 8 Issue 2: September 14, 2010PDF download

Colorectal Cancer Screening Using Flexible Sigmoidoscopy: United Kingdom Study Demonstrates Significant Incidence and Mortality Benefit

Colorectal Cancer Screening Using Flexible Sigmoidoscopy: United Kingdom Study Demonstrates Significant Incidence and Mortality Benefit

Building your Babylon

Ron Bridges is the Head of the Division of Gastroenterology for the Calgary Health Region (CHR) and a Clinical Professor of Medicine at the University of Alberta. He has been actively involved in the development of the Forzani and MacPhail Colon Cancer Screening Centre (CCSC) at the University of Calgary, and has been the Medical Director for the centre during the formative planning and implementation stages.