Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | luni, 21 ianuarie 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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SCREENING FOR COLORECTAL CANCER WITH FECAL OCCULT BLOOD TESTING AND COLONOSCOPY: CORRELATION OF CLINICAL DATA, SITE, SIZE AND DISEASE’S STAGE
Iuliana Taraşi (1), Gabriela Florenţa Dumitrescu (2), Anca Indrei (3), P. Plămădeală (4),
Anca Trifan (5), C. Stanciu (5)
(1) Departament of Gastroenterology, „St. Spiridon” Emergency Clinical Hospital Iaşi
(2) Department of Pathology, „Prof. Dr. N. Oblu” Emergency Clinical Hospital Iaşi
(3) Department of Anatomy and Embriology,
„Gr.T. Popa” University of Medicine and Pharmacy Iasi
(4) Department of Pathology, „St. Mary” Emergency Clinical Hospital Iaşi
(5) Institute of Gastroenterology Iaşi
Jurnalul de chirurgie 2009; 5 (2): 153-164
Full text:
Format PDF (Engleză/English)

Abstract:

Aim: We present the main results from a combined screening study for colorectal cancer carried out in an asymptomatic population from Iaşi, Romania, during 2004-2007, adopting a combination of faecal occult blood testing (FOBT) and full colonoscopy. The primary aim of the current study was to determine the location of polyps and cancers and the prevalence of advanced histologic features in colorectal lesions removed by polipectomy followed or not by surgery. Secondary aim was to determine whether there were any risk factors for advanced histology in each patient group. Material and methods: Overall, 1291 asymptomatic subjects were screened. Patients were divided into groups, based on age: 50-59 yr, 60-69 yr, and ≥70 years, which were statistically analyzed. Results: Using FOBT and full colonoscopy with polypectomy as combined screening tools we were able to identified 38 cases (2.94%) of polypoid lesions (non-neoplastic and neoplastic) and colorectal cancers. 1.85% subjects from all eligible subjects were found to have advanced neoplasia and 43.75% of them had advanced histology. Taking into consideration colorectal adenomas, there were a predominance of male subjects in 50-59 age group (31.25%), but their histology was not an advanced one. As age increases to ≥70 years old, the tendency is for women subjects with villous architecture with high-grade dysplasia to predominate (18.5%). Proximal site was associated with smaller size of neoplastic polyps (<40 mm), and tubular architecture with or without non-invasive low-grade dysplasia. Distal colon expressed all histopathological types with all kind of grades of dysplasia, but 12.5% of cases were associated with greatest sizes (≥40mm), villous architecture with non-invasive high-grade dysplasia. We detected 8 (21.05%) cancers from all positive FOBT and colonoscopic detected lesions. The mean age of subjects with colorectal cancers was greater than that of subjects with colorectal adenomas (64.125 vs 61.125 years old). We found a male predominance and a predominant 50-59 years age group affected by the disease. There was an equal distribution on the left and right sided cancers. Most subjects, especially those in 50-59 group age were in stage II (87.5%), but there was a stage I colorectal cancer detected in a 60-69 years age group male. On histopathological examination adenocarcinoma was the commonest type (87.5%). Conclusions: Some aspects like the older age at presentation (mean age 64.125 years), equal right to left site location, and 12.5% cancers showing early stage (I) can be consider similar to that reported in Western countries. Some others epidemiological features like delayed presentation of the disease in an advanced stage (87.5%) make our population similar to that from developing countries. Our study prove that colonoscopy can be a useful screening tool when is applied to average-risk people who had a positive FBOT. We support the urgent need to screen asymptomatic subjects as high percentage of locally advanced tumors was detected.

KEY WORDS: POLYP, CANCER, COLORECTAL, COLONOSCOPY, FBOT

Correspondence to: Iuliana Taraşi, MD; e-mail:



: Creative Commons License
Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.