User:Danielleswikipage/sandbox

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Practice Editing Here (Nov 23rd in-class Wiki session work)

 * This is a place to practice clicking the "edit" button and practice adding references (via the citation button).
 * Hereditary nonpolyposis colorectal cancer

Assignment # 3

 * 1) Proposed Changes:

Addition to the Prevention section (underneath the subheading ‘screening’)

(This change should be added after the first sentence of the section which discusses genetic counselling, and before the discussion of ovarian cancer screening):

Colonoscopies are strongly recommended as a preventative method of surveillance for individuals who have Lynch syndrome, or LS-associated genes. Specifically, it is recommended that colonoscopies begin at age 25 for MLH1 and MSH2 mutation carriers and 35 years for MSH6 and PMS2 mutation carriers. Colonoscopic surveillance should then be performed at a 2 year interval for Lynch Syndrome patients.


 * 1) Rationale:

Currently, the prevention and screening section of the Hereditary nonpolyposis colorectal cancer only moderately discusses prevention techniques: such as taking aspirin or receiving genetic counselling if families meet the Amsterdam criteria. However, the article completely lacks information about the use of quality and advanced endoscopic imaging in colonoscopic surveillance. The screening section only discusses the use of ultrasounds and biopsies for annual ovarian and endometrial cancer screening. However, it fails to go into detail specific for screening for colon cancer. In fact, the entire article does not mention colonoscopies even once. The guidelines from the British Society of Gastroenterology, recommend colonoscopies as the gold standard diagnostic and preventative method of surveillance. Further research from a systematic review and network meta-analysis found that sigmoidoscopies and colonoscopies reduce colorectal incidence and colorectal cancer mortality (especially in men). As a result, I have decided to add three sentences (information which came from the second source cited below) which discuss the use of colonoscopy in screening for colorectal cancer. The addition specifically discusses the differences in protocol for moderate and high-risk family members and articulates that follow-up colonoscopy surveillance may differ in nations depending on surveillance guidelines (addressing any national critiques). There are no areas of ambiguity or controversy for this proposed change.

1Jodal, H. C., Helsingen, L. M., Anderson, J. C., Lytvyn, L., Vandvik, P. O., & Emilsson, L. (2019). Colorectal cancer screening with faecal testing, sigmoidoscopy or colonoscopy: a systematic review and network meta-analysis. BMJ open, 9(10), e032773. https://doi.org/10.1136/bmjopen-2019-032773

2Monahan, K. J., Bradshaw, N., Dolwani, S., Desouza, B., Dunlop, M. G., East, J. E., Ilyas, M., Kaur, A., Lalloo, F., Latchford, A., Rutter, M. D., Tomlinson, I., Thomas, H., Hill, J., & Hereditary CRC guidelines eDelphi consensus group (2020). Guidelines for the management of hereditary colorectal cancer from the British Society of Gastroenterology (BSG)/Association of Coloproctology of Great Britain and Ireland (ACPGBI)/United Kingdom Cancer Genetics Group (UKCGG). Gut, 69(3), 411–444. https://doi.org/10.1136/gutjnl-2019-319915


 * 1) Critique of Source:

The secondary source that I used cited an observational study on colonoscopy data from countries with different lynch syndrome surveillance policies. The largest limitation that came from this information would be that there may be non-compliance with country-specific surveillance protocols. However, ultimately this information is supported by multiple other systematic reviews and the author even concludes that these are fairly minute limitations in the large scheme of things. Additionally, another critique could be that the information comes from United Kingdom guidelines specifically (and thus is not representative of all countries). Ultimately, though, these are colonoscopy recommendations that tend to be consistent across  most countries and it will be cited properly so viewers are able to see distinctly where the information comes from.


 * 1) Article Improvement

My proposed improvements and references have been shared on the talk page.

What to post on the Wikipedia article talk page?

 * This will also be covered on Nov 23rd in class. Your group should use the below template to share an outline of your proposed improvements (including your new wording and citations). Article talk pages are not places to share your assignment answers. The Wikipedia community will be more interested in viewing your exact article improvement suggestions including where you plan to improve the article (which section), what wording you suggest, and the exact citation (Note: all citations must meet WP:MEDRS)
 * You will not be able to paste citations directly from your sandbox to talk pages (unless you are interested in editing/learning Wiki-code in the "source editing" mode). We suggest re-adding your citations on the talk page manually (using the cite button and populating the citation by pasting in the DOI, website, or PMID). You will have to repeat this process yet again when you edit the actual article live.
 * Talk Page Template: CARL Medical Editing Initiative/Fall 2020/Talk Page Template