Programa multicéntrico de cribado de cáncer colorrectal en Chile
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 p...
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Sociedad Médica de Santiago
2018
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oai:scielo:S0034-988720180006006852018-08-24Programa multicéntrico de cribado de cáncer colorrectal en ChileLópez-Kostner,FranciscoZárate,Alejandro J.Ponce,AlejandraKronberg,UdoKawachi,HiroshiOkada,TakuyaTsubaki,MasahiroIto,TakashiNishikage,TetsuroTanaka,KojiKawano,TatsuyukiEishi,YoshinobuPeñaloza,PaulinaEstela,RicardoKarelovic,StankoFlores,Sergio Colorectal Neoplasms Early Detection of Cancer Endoscopy 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.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.146 n.6 20182018-06-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000600685es10.4067/s0034-98872018000600685 |
| institution |
Scielo Chile |
| collection |
Scielo Chile |
| language |
Spanish / Castilian |
| topic |
Colorectal Neoplasms Early Detection of Cancer Endoscopy |
| spellingShingle |
Colorectal Neoplasms Early Detection of Cancer Endoscopy López-Kostner,Francisco Zárate,Alejandro J. Ponce,Alejandra Kronberg,Udo Kawachi,Hiroshi Okada,Takuya Tsubaki,Masahiro Ito,Takashi Nishikage,Tetsuro Tanaka,Koji Kawano,Tatsuyuki Eishi,Yoshinobu Peñaloza,Paulina Estela,Ricardo Karelovic,Stanko Flores,Sergio Programa multicéntrico de cribado de cáncer colorrectal en Chile |
| description |
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. |
| author |
López-Kostner,Francisco Zárate,Alejandro J. Ponce,Alejandra Kronberg,Udo Kawachi,Hiroshi Okada,Takuya Tsubaki,Masahiro Ito,Takashi Nishikage,Tetsuro Tanaka,Koji Kawano,Tatsuyuki Eishi,Yoshinobu Peñaloza,Paulina Estela,Ricardo Karelovic,Stanko Flores,Sergio |
| author_facet |
López-Kostner,Francisco Zárate,Alejandro J. Ponce,Alejandra Kronberg,Udo Kawachi,Hiroshi Okada,Takuya Tsubaki,Masahiro Ito,Takashi Nishikage,Tetsuro Tanaka,Koji Kawano,Tatsuyuki Eishi,Yoshinobu Peñaloza,Paulina Estela,Ricardo Karelovic,Stanko Flores,Sergio |
| author_sort |
López-Kostner,Francisco |
| title |
Programa multicéntrico de cribado de cáncer colorrectal en Chile |
| title_short |
Programa multicéntrico de cribado de cáncer colorrectal en Chile |
| title_full |
Programa multicéntrico de cribado de cáncer colorrectal en Chile |
| title_fullStr |
Programa multicéntrico de cribado de cáncer colorrectal en Chile |
| title_full_unstemmed |
Programa multicéntrico de cribado de cáncer colorrectal en Chile |
| title_sort |
programa multicéntrico de cribado de cáncer colorrectal en chile |
| publisher |
Sociedad Médica de Santiago |
| publishDate |
2018 |
| url |
http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000600685 |
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