Increased colorectal cancer (CRC) incidence in middle-aged adults (Mayo Clinic

2022). Lifestyle factors, environmental factors, delayed diagnosis, and family history
are associated with the risk of colon cancer. Siegel et al. (2023) conducted a
statistical analysis on early onset of colorectal cancer. Based on the analysis rates,
CRC increased in middle-aged adults by 1.9% per year from 2011 through 2019.
The National Cancer Institute reports: “The rate of new cases of colorectal cancer
was 36.5 per 100,000 men and women per year. The death rate was 12.9 per
100,000 men and women per year” (Rate of New Cases and Deaths Section). The
current recommendation is for people to start colonoscopy at age 45.

Clinical Question

In middle-aged adults, how does colonoscopy screening affect risk of colorectal cancer and
survival rates?

 Practice Recommendations (5 points). The content provides a detailed description about all 3

Bretthauer et al. (2022) conducted a randomized trial on 84,585 participants with a median age
of 59 years old. The participants were divided into two groups. The invited group was assigned
to colonoscopy screening, and the usual-care group was not assigned to colonoscopy. Over 10
years, the risk of CRC in the invited group was 0.98%, and 1.20% in the usual-care group. The
death rate in the invited group was 0.28%, and 0.31% in the invited group. Participants, who
were asked to have screening colonoscopy had a decreased risk of colorectal cancer. The author
inferred that the study findings may help with the efficacy of colonoscopy screening in
preventing CRC (Bretthauer et al., 2022). Nurses play an important role in CRC prevention.
They can advise patients to do early colonoscopy screening, identify colon cancer’s symptoms,
and provide education about risk factors.
 Project Proposal (8 points) The content provides a detailed description about all 4 Project Proposal
bullets with 6 or more sentences

 Based on the recommendations and implications for nursing practice from the article,
introduce an EBP proposal.
 What is the purpose or goal of the project?
 What is the need for the project?
 What outcome(s) does the team want to achieve

Meet with staff and providers to address the need of screening with evidence-based
recommendations

Set up a meeting with nurses to address the incidence of increased CRC with the proposal of
starting a colonoscopy at 45. Provide the rates of stage III and stage IV CRC diagnosed at the
clinic in the last 12 months. Educate nurses about importance of colonoscopy screening,
prevention of CRC and early symptoms.

The purposed of the project to inc

References

Addressing the rising incidence of early-onset colorectal cancer - Mayo Clinic. (2022, December

14). https://www.mayoclinic.org/medical-professionals/news/addressing-the-rising-

incidence-of-early-onset-colorectal-cancer/mac-20541392

Bretthauer, M., Løberg, M., Wieszczy, P., Kalager, M., Emilsson, L., Garborg, K., Rupinski, M.,

Dekker, E., Spaander, M., Bugajski, M., Holme, Ø., Zauber, A. G., Pilonis, N. D., Mroz,

A., Kuipers, E. J., Shi, J., Hernán, M. A., Adami, H., Regula, J., . . . Kaminski, M. F.

(2022b). Effect of colonoscopy screening on risks of colorectal cancer and related death.

New England Journal of Medicine/˜the œNew England Journal of Medicine, 387(17),

1547–1556. https://doi.org/10.1056/nejmoa2208375

Cancer of the colon and rectum - Cancer Stat Facts. (n.d.-b). SEER.

https://seer.cancer.gov/statfacts/html/colorect.html

Siegel, R. L., Wagle, N. S., Cercek, A., Smith, R. A., & Jemal, A. (2023). Colorectal cancer

statistics, 2023. Ca, 73(3), 233–254. https://doi.org/10.3322/caac.21772

Introduction.
Colorectal cancer (CRC) ranks as the second most common cause of cancer-related death in the
United States. ). Colonoscopy screening is recommended to decrease mortality rates (Siegel et al.,
2023c).

Colorectal cancer screening (CRCS) is recommended by the World Health Organization (WHO) as a
prevention to reduce morbidity and mortality (CDC,2020; World Health Organization, 2020).

Increased colorectal cancer (CRC) incidence in middle-aged adults (Mayo Clinic 2022).
Lifestyle factors, environmental factors, delayed diagnosis, and family history are associated
with the risk of colon cancer. Siegel et al. (2023) conducted a statistical analysis on early onset
of colorectal cancer. Based on the analysis rates, CRC increased in middle-aged adults by 1.9%
per year from 2011 through 2019. The National Cancer Institute reports: “The rate of new cases
of colorectal cancer was 36.5 per 100,000 men and women per year. The death rate was 12.9 per
100,000 men and women per year” (Rate of New Cases and Deaths Section). The current
recommendation is for people to start colonoscopy at age 45.
Clinical Question
In middle-aged adults, how does colonoscopy screening affect risk of colorectal cancer and
survival rates?
 Practice Recommendations (5 points). The content provides a detailed description of all
3
Bretthauer et al. (2022) conducted a randomized trial on 84,585 participants with a median age
of 59 years old. The participants were divided into two groups. The invited group was assigned
to colonoscopy screening, and the usual-care group was not assigned to colonoscopy. Over 10
years, the risk of CRC in the invited group was 0.98%, and 1.20% in the usual-care group. The
death rate in the invited group was 0.28%, and 0.31% in the invited group. Participants, who
were asked to have screening colonoscopy had a decreased risk of colorectal cancer. The author
inferred that the study findings may help with the efficacy of colonoscopy screening in
preventing CRC (Bretthauer et al., 2022). Nurses play an important role in CRC prevention.
They can advise patients to do early colonoscopy screening, identify colon cancer’s symptoms,
and provide education about risk factors.
 Project Proposal (8 points) The content provides a detailed description of all 4 Project
Proposalbullets with 6 or more sentences
 Based on the recommendations and implications for nursing practice from the article,
introduce an EBP proposal.
 What is the purpose or goal of the project?
 What is the need for the project?
 What outcome(s) does the team want to achieve
Set up a meeting with nurses to address the incidence of increased CRC with the proposal of
starting a colonoscopy at 45. Provide the rates of stage III and stage IV CRC diagnosed at the
clinic in the last 12 months. Educate nurses about importance of colonoscopy screening,
prevention of CRC and early symptoms. The purpose of the project is to increase colonoscopy
screening in the clinical setting, and decrease diagnosis rates of stage III and stage IV colorectal
cancer. The need for this project is to decrease the death of CRC and detect it at an earlier stage.
Patients may not experience symptoms in the early stage of CRC, but colonoscopy screening can
detect polyps or tumors that have not metastasized. The outcome of the project is the prevention
and detection of CRC cancer at an earlier stage. If polyps are detected, the procedure of removal
is performed with patient agreement. After 12 months, set up a meeting with nurses and provide
them with rates of stage III and stage IV of CRC diagnoses that were performed at the clinic.
CONCLUSION
Diagnoses of CRC in middle-aged adults are increasing, and the current recommendation to start
colonoscopy at the age of 45 may. Primary care clinic is the place where colon cancer can be
prevented during routing check up. Nurses play a vital role in educating patients about the
prevention of CRC, early symptoms, and risk factors. For nurses, it’s important to build patient
trust do not feel embarrassed talking about hemorrhoids, diarrhea, or constipation issues.
Recommending early colonoscopy screening may save a life and prolong living.
References
References
Addressing the rising incidence of early-onset colorectal cancer - Mayo Clinic. (2022, December
14). https://www.mayoclinic.org/medical-professionals/news/addressing-the-rising-incidence-of-
early-onset-colorectal-cancer/mac-20541392
Bretthauer, M., Løberg, M., Wieszczy, P., Kalager, M., Emilsson, L., Garborg, K., Rupinski, M.,
Dekker, E., Spaander, M., Bugajski, M., Holme, Ø., Zauber, A. G., Pilonis, N. D., Mroz, A.,
Kuipers, E. J., Shi, J., Hernán, M. A., Adami, H., Regula, J., . . . Kaminski, M. F. (2022b). Effect
of colonoscopy screening on risks of colorectal cancer and related death. New England Journal
of Medicine/˜the œNew England Journal of Medicine, 387(17), 1547–1556.
https://doi.org/10.1056/nejmoa2208375
Siegel, R. L., Wagle, N. S., Cercek, A., Smith, R. A., & Jemal, A. (2023c). Colorectal cancer

statistics, 2023. Ca, 73(3), 233–254. https://doi.org/10.3322/caac.21772