Colorectal cancer screening in LHU4 Chiavarese, Italy: ethical, methodological and outcome evaluations at the end of the first round.

UNLABELLED: INTRODUCTION. The screening programmes are very challenging from the ethical perspective, and their impact in terms of morbidity and mortality make secondary colorectal cancer prevention a valuable public health intervention. METHODS: The target population people aged 50-69 years receive an invitation card with a test-tube for the fecal occult blood test (FOBT) and an immunochemical test is used for fecal occult blood. Subjects positive to FOBT are invited to perform a gastroenterologic examination and a full colonoscopy. RESULTS: In the firt round of screening, 100% of the target population has been invited with an adhesion rate of 41.3%. A total of 1739 FOBT-positive subjects have been invited to the second level of the screening. 1429 of them have performed the gastroenterologic examination (83.9%). To date 956 full colonoscopies have been completed and the rate of subjects affected by carcinoma, malignant polyp and advanced adenoma has been equal to 23.5%. DISCUSSION: Thanks to the reminders already sent, an increasing compliance has been registered with an increased rate of subjects with a low schooling that have performed a FOBT test. With the aim to optimize all the operative aspects of the screening programme it is already ongoing a set of meetings between health workers of Local Health Unit 4 and General Practioners.

[Automated blood cell measurements: a comparison between the Bayer H2 and the Abbott Cell-Dyn 3500]. / L'esame emocromocitometrico in automazione: confronto tra Bayer H2 e Abbott Cell-Dyn 3500.

INTRODUCTION: We have compared two hematologic analyzers, H2 (Bayer) and CELL DYN 3500 (Abbott). The protocol we used was able to evaluate the overall analytical quality, the effect of aging of the sample on the measured parameters, the quality of leucocytes differential count. Number and quality of information supplied for each sample by both analyzers were then taken in account. RESULTS: Excellent correlation for all measured parameters was found: only monocytes were, albeit modestly, overestimated by CELL DYN 3500 compared to H2. Ageing of sample and temperature of storage had a marked effect on CELL DYN's measurements, resulting in impaired recognition and classification of leucocytes, while the results for the other parameters were acceptable. Comparative evaluation of the differential count of leucocytes was made between the results of both analyzers and microscopic examination. While specificity, predictive value of negative results and quantity of false negative results were practically the same, sensitivity, predictive value of positive results and quantity of false positive results were better for H2 as compared to CELL DYN (87.1% vs 78.1%, 79.4% vs 65.8, 7 vs 13, respectively). The clinical utility of supplementary informations (alarms, flags, cytograms, etc.) yielded by the analyzers was relevant for H2 regarding the erythrocytes cytograms, for CELL-DYN 3500 regarding the application of the extended lyse program for lytic resistant RBCs and of the Vet Package. CONCLUSIONS: CELL DYN 3500 performance have on the whole confirmed the producer's claims, being of reliable use in the haematological screening on account of its simplicity and more than good overall analytical quality.