ABSTRACT
Background: Mortality from colorectal cancer (CCR) in Chile has nearly doubled over the past 15 years. International studies have shown that CCR screening programs based on fecal occult blood test (FOBT) reduce CCR mortality. Aim: To analyze the results from a CCR screening model in people over 50 years. Material and Methods: Between 2007 and 2009, a prospective multicenter study was performed in seven major Chilean cities. FOBT using an immunological method, was measured in asymptomatic subjects aged 50 years or more, without risk factors. In patients with a positive FOBT, with symptoms or with family risk factors, a colonoscopy was indicated. Results: A total of 6348 subjects were assessed, FOBT was performed in 4938 of them, with a compliance of 77%. The result was positive in 9.6%. A total of 2359 colonoscopies were ordered, with an overall compliance of 50.1%. Of the 1184 colonoscopies performed, adenomas and high risk adenomas were found in 304 (26%) and 75 (6%) patients, respectively. Thirteen patients were diagnosed with stage I and IICCR. Three of these lesions were excised endoscopically and 10 surgically. The detection rate of polyps, high risk adenomas and cancer was 75, 12 and 2 per 1000 screened individuals, respectively. Conclusions: This program allowed the early detection of an important number of high risk colon lesions, and all patients with CCR were diagnosed at early stages.
Subject(s)
Humans , Middle Aged , Adenomatous Polyps/diagnosis , Colorectal Neoplasms/diagnosis , Early Detection of Cancer/methods , Mass Screening/methods , Occult Blood , Adenomatous Polyps/mortality , Age Factors , Chile/epidemiology , Colonoscopy , Colorectal Neoplasms/mortality , Patient Compliance , Program Evaluation , Prospective Studies , Risk Factors , Urban PopulationABSTRACT
Se estudiaron los efectos clínicos y de laboratorio, secundarios a la uretrocistografía en 104 pacientes, distribuidos al azar en dos grupos comparables en edad, sexo y tiempo de permanencia de la sonda vesical: uno tratado con nitrofurantoina en macrocristales durante 5 días (Grupo A, 53 pacientes) y otro no (Grupo B, 51 pacientes). Se efectuaron controles clínicos y exámenes de orina seriados (urocultivo y sedimento) antes, durante y después del examen radiológico. No se encontró evidencia de infección urinaria relacionada con el procedimiento entre los pacientes del Grupo A, en contrastre con una incidencia de 9,8% de ésta entre los niños controles. Después del procedimiento se detectó globo vesical en 11 casos (12%), disuria en 30 pacientes (32,6%) y hematuria microscópica en 22 niños (24%), sin encontrar diferencias significativas entre ambos grupos. Parece recomendable emplear profilaxis antimicrobiano para evitar contaminación o infección del tracto urinario que resulten de la realización de uretrocistografía u otros procedimientos que requieren del uso de sondas vesicales