ABSTRACT
Introduction: In terms of frequency, colorectal cancer is the 3rd cancer in Lebanon with 1093 incidences registered in 2015. However, to this date not a single screening campaign has been organized in the country. Fecal immunochemical test [FIT] is a technique being more and more advised in screening. This being said, we found it useful to organize a screening campaign using FIT in order to determine the prevalence of colorectal cancer in a population of 3000 healthy Lebanese in order to extract useful data
Material and Methods: Healthy Lebanese adults of average risk of developing colorectal cancer between 45 and 80 years old. Procedure: 3000 sampling tubes were distributed. Numerous presentations were done to explain the screening modalities and its importance. In order to preserve the sample quality, patients were asked to return the tubes within 3 days of doing the test. Once the hemoglobin quantification has been done at the medical genetics unit [UGM] of Saint-Joseph University, patients with stool hemoglobin of more than 80ng/ml were contacted and answered few questions then were asked to undergo a colonoscopy. Follow-up is still ongoing as well as sampling kits distribution
Results o Out of the 3000 distributed tests, 705 were returned [23.5 percent]. 528 were presented with enough data to be studied and out of them 459 answered the inclusion criteria. The cohort median for age was 56 years old [45-80]. Sex ratio F/M 2.3, among them 4 percent had personal cancer history, 14 percent had familial history of colorectal cancer and 20 percent underwent colonoscopies at least once in their life. Out of the 459 patients, 278 [60.5 percent] showed 0 ng/ml, 137 [29.8 percent] showed 1 to 79 ng/ml, 3 [0.6 percent] showed 80 to 99 ng/ml meaning they are at intermediate risk, 33 [7.1 percent] showed 100 to 800 ng/ml considered as a positive value and finally 8 [1.7 percent] showed over range values. Among the 44 positive patients we contacted 41, directly or by their referent physician. Out of the 8 [18 percent] colonoscopies results received so far, 5 had hemorrhoids causing false positive results. One had ulcerative ileitis. For the remaining 2, tubular adenomas of low grade were discovered, while for one of them a carcinoma was discovered
Conclusion: While it was hard for us to quantify people for whom a free FIT was proposed, the low restitution rate among those who accepted to undergo the test shows the urgent necessity of establishing sensitization and screening campaigns. This takes a particular dimension knowing that some patients with positive FIT refused further investigations