ABSTRACT
Background: Colorectal Cancer Screening Programs (CRCSP) are widely accepted in developed countries. Unfortunately, financial restrictions, low adherence rate and variability on colonoscopy standardization hamper the implementation of CRCSP in developing countries. Aim: To analyze a multicentric pilot model of CRCSP in Chile. Material and Methods: A prospective model of CRCSP was carried out in three cities, from 2012 to 2015. The model was based on CRC risk assessment and patient education. Health care personnel were trained about logistics and protocols. The endoscopy team was trained about colonoscopy standards. A registered nurse was the coordinator in each center. We screened asymptomatic population aged between 50 and 75 years. Immunological fecal occult blood test (FIT) was offered to all participants. Subjects with positive FIT underwent colonoscopy. Results: A total of 12,668 individuals were enrolled, with a FIT compliance rate of 93.9% and 2,358 colonoscopies were performed. Two hundred and fifty high-risk adenomas and 110 cancer cases were diagnosed. One patient died before treatment due to cardiovascular disease, 74 patients (67%) underwent endoscopic resection and 35 had surgical treatment. Ninety one percent of patients had an early stage CRC (0-I-II). Among colonoscopy indicators, 80% of cases had an adequate bowel preparation (Boston > 6), cecal intubation rate was 97.7%, adenoma detection rate was 36.5%, and in 94.5% of colonoscopies, withdrawal time was adequate (> 8 min). Conclusions: This CRCS pilot model was associated to a high rate of FIT return and colonoscopy quality standards. Most CRCs detected with the program were treated by endoscopic resection.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Colorectal Neoplasms/diagnosis , Program Evaluation , Adenoma/diagnosis , Colonoscopy/methods , Risk Assessment/methods , Early Detection of Cancer/methods , Colorectal Neoplasms/pathology , Adenoma/pathology , Chile , Pilot Projects , Nutritional Status , Patient Education as Topic , Prospective Studies , Reproducibility of Results , Risk Factors , Analysis of Variance , Colonoscopy/standards , Early Detection of Cancer/standards , Occult BloodABSTRACT
El cáncer de ovario es la segunda neoplasia maligna ginecológica más común, pero la principal causa de muerte entre las mujeres que padecen algún cáncer ginecológico. El hallazgo de metástasis a distancia en cáncer de ovario tanto en el diagnostico como durante el seguimiento, se encuentra en cerca del 18 por ciento de las pacientes. Las metástasis en piel se han reportado en cifras menores a un 4 por ciento. El compromiso cutáneo se ha descrito como un fenómeno tardío en la historia natural de la, enfermedad, reportándose una sobrevida promedio de 4 meses, posterior al hallazgo de la metástasis en piel. En éste trabajo se reporta el caso de una paciente con éste tipo de diseminación metastásica en piel, junto con una revisión bibliográfica del tema.
Ovarian carcinoma is the second most common gynecologic neoplasm, but it is still the main cause of death among the gynecologic tumors in women. Distant metastases are found in 18 percent of the patients with ovarian carcinoma. Skin metastases of ovarian carcinoma are very rare. It has been reported in almost 4 percent and in some cases as the first manifestation of the disease. Skin metastases have been described as a late manifestation during the natural history of the disease, reporting an average of 4 month survival after the finding of skin lesions. In this paper a case of a patient with this type of metastatic dissemination on skin is reported, including a bibliographic review of the literature.