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Implementation of a data system to better characterize Brazilian colorectal cancer screening population
Brazil (IFMSA-Brazil) - Faculdade de Ciencias da Saude de Barretos Dr. Paulo Prata, Barretos
Department of Endoscopy R. Antenor Duarte Viléla, 1331 - Dr. Paulo Prata, Barretos - SP, 14784-400, Brazil
Denise Peixoto Guimarães
Denise Peixoto Guimarães
English, Portuguese and Spanish
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
According to incidence estimates of the National Cancer Institute (Instituto Nacional de Câncer, INCA-MS), colorectal cancer (CRC) is the third most common type of cancer among men and the second most common type among women in Brazil in 2018. Despite the high incidence and significance of CRC in Brazil, very little is known about its prevalence among the asymptomatic population. Screening for CRC can reduce both the incidence and mortality through detection of cancer in the early stages and can prevent its occurrence via removal of precursor lesions. Recently, a CRC screening program was implemented at the Barretos Cancer Hospital (HCB). Characterization of the clinical findings detected in the screening population and the prevalence of basal CRC might contribute to better organization of the program and define the best strategy for a future national screening program. We hypothesize that recruitment and the early outcomes of our screening program based on the fecal immunochemical test (FIT) will differ from the outcomes corresponding to other populations due to sociodemographic differences.
What is the aim of the project?
To measure early outcomes (adenoma, advanced adenoma and cancer) and associate them with sociodemographic risk factors; ii. to quantify the risk of CRC in the Brazilian population and to develop algorithms for risk stratification of CRC screening comparing the risk with other countries.
What techniques and methods are used?
Individuals aged 50 to 65 years will be included in the HCB screening program from January 2017 to December 2017. At entry in the program, the following data will be collected from all participants: sociodemographic and ethnic (skin color) characteristics; risk factors for CRC, such as smoking and drinking; comorbidities, including diabetes mellitus and arterial hypertension; and FIT, colonoscopy and histopathology examination results. Data collection will be performed using the REDCap data collection/database system. The risk score will be formulated as follows: first, the relationships between the participants’ characteristics and the outcomes (Cancer/No Cancer) will be investigated using the Chi-square test (or Fisher’s exact test) and simple logistic regression, and the regression coefficients will be calculated. Then, the model identified for the training sample will be replicated with a validation sample. The resulting score will be used to calculate the sensitivity, specificity, positive predictive value, negative predictive value, accuracy, area under the receiver operating characteristic (ROC) curve and Kolmogorov D statistic.
What is the role of the student?
- The student will mainly observe
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
The student is expected to have a good attitude toward learning, to have an understanding of the research process. The student is expected to acquire science process skills, such as, critical analysis of primary literature and data interpretation. It is expected that the student knows how to process data or, at least, have the wish to learn about. The student will work with the data collecting supervised by the group and/or the tutor, who will be translating during the process when Portuguese is required. After the collected data from the research will be a discussion along with the group ways to improve the existing characterization system.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Preliminary readings and research meetings will be provided for the students by the tutor. The tutor will also provide articles and mini-lectures.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a presentation - The student will prepare an abstract
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Be able to work in group, be organized and committed to the study itself.
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students
- US Preventive Services Task Force; Bibbins-Domingo K; Grossman DC; Curry SJ; Davidson KW; Epling JW Jr; García FAR; Gillman MW; Harper DM; Kemper AR; Krist AH; Kurth AE; Landefeld CS; Mangione CM; Owens DK; Phillips WR; Phipps MG; Pignone MP; Siu AL. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016 Jun 21;315(23):2564-2575.
- Souza DL; Jerez-Roig J; Cabral FJ; de Lima JR; Rutalira MK; Costa JA.Colorectal cancer mortality in Brazil: predictions until the year 2025 and cancer control implications.Dis Colon Rectum. 2014 Sep;57(9):1082-9.
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