ABSTRACT
AIM: The aim of the study was to evaluate the benefit of the immunochemical fecal blood test (FIT) for detection of advanced adenomas. MATERIAL AND METHODS: We have conducted a screening study on a average-risk cohort of subjects, aged 50 -74 years. We used a rapid quantitative FIT to perform the screening. Colonoscopy was recommended in all participants with positive FIT. We assessed the participation rate and analyzed advanced adenomas detected in the screening examinations. RESULTS: Our study enrolled 1111 asymptomatic participants. Immunochemical test results were positive in 72 subjects (6.5%). Colonoscopy was performed by 50/72 (69.4%) subjects. The detection rate for advanced adenomas was 2.2%. A total number of 28 advanced adenomas were detected in 24 subjects, meaning 1.2 advanced adenoma/subject. Analyzing the 3 characteristics of advanced adenomas, we observed in our study that 25/28 adenomas (89.3%) had sizes > or = 10 mm, 11/28 adenomas (39.3%) were tubulovillous/villous and 19/28 adenomas (67.9%) had high dysplasia. The majority of advanced adenomas were found in the left colon as compared to the right colon: 71.4% vs. 28.6%. p = 0.0008. CONCLUSIONS: In our study was obtained a 2.2% detection rate for advanced adenomas, most of them (71.4%) being located in the left colon. The dominant feature of advanced adenomas detected was the size > or = 10 mm (89.3% of cases).
Subject(s)
Adenoma/diagnosis , Colorectal Neoplasms/diagnosis , Mass Screening , Occult Blood , Adenoma/epidemiology , Aged , Cohort Studies , Colon, Ascending/pathology , Colon, Descending/pathology , Colonoscopy , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/prevention & control , Early Detection of Cancer , Female , Humans , Immunochemistry/methods , Incidence , Indicators and Reagents , Male , Mass Screening/methods , Middle Aged , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
UNLABELLED: The aim of the paper was to evaluate the national availability of colonoscopy and the quality parameters of this procedure in our country. MATERIAL AND METHOD: During a 6 months period (01.07- 31.12.2009), we performed a prospective multicenter study in which 76 centers were invited to respond to a questionnaire regarding colonoscopy, 39 centers agreeing to participate. We assessed: the number of colonoscopies, the number of total colonoscopies and the causes of incomplete colonoscopies. RESULTS: During the study period, 16,083 colonoscopies were performed, 12,294 (76.4%) of them total colonoscopies. In 1,191 cases, stenosis was the cause of incomplete colonoscopy. If we consider this an objective reason for an incomplete colonoscopy, there were 12,294 total colonoscopies (82.4%). Comparing university centers with non-university ones, the proportion of total colonoscopies was 10,400/12,475 (83.4%) vs. 1,894/2,417 (78.4%) (p less then 0.0001). However, comparing the present study with previous ones, performed in 2003 and 2007, the proportion of total colonoscopies increased from 70.5% to 76.9% and 82.4% respectively (2003 vs. 2007 p less then 0.0001; 2007 vs. 2009 p less then 0.0001), while the quality difference between university and non-university hospitals persisted. CONCLUSIONS: the quality of colonoscopy in Romania increased in the last 5 years, while the quality difference between university and non-university hospitals persisted.
