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PA.118 OBSERVATIONS AND RESULTS OF THE FIRST ROUND OF COLORECTAL CANCER SCREENING PROGRAMME IN RIMINI
S118
Abstracts / Digestive and Liver Disease 40S (2008), S1–S195
the importance of prevention in colorectal cancer, and suggests the best diagnostic procedure: colonoscopy. If the patient refuses to undergo this procedure we suggest barium enema or virtual TC. Results: In the biennium 2005-2007, 49749 people (26156 females and 23593 males) were invited to carry out FOBT test. Of these, 406 were excluded due to the fact that they had carried out either FOBT test or colonoscopy recently. 21432 people (43.4%) performed the test: 20149 (94.1%) negative and 1281 (5.9%) positive. Of those who tested positive for FOBT 1155 (91%) underwent a colonoscopy. Up until August 2007, 678 colonoscopies have been performed, with the following results: 62 adenocarcinomas stage Duke A (9.1%), 35 malignant polyps (5.1%), 251 high-grade adenomas (37%), 282 low-grade adenomas (41.5%), according to regional research criteria. Conclusions: An appropriate screening campaign allows for early diagnosis of colorectal cancer. The efficiency of the screening campaign depends on a high adhesion of those members of the community who are at risk. Good organization is of fundamental importance for a high participation in the screening campaign # J. GI Oncology 3. Screenings
PA.118 OBSERVATIONS AND RESULTS OF THE FIRST ROUND OF COLORECTAL CANCER SCREENING PROGRAMME IN RIMINI M. Giovanardi 1 , C. Casale 1 , C. Balducci 1 , I. Panzini 1 , O. Giuliani 2 , D. Canuti 1 , C. Fava 1 , F. Santilli 1 , M. Di Marco 1 , F. Desiderio 1 1 Ospedale
“Infermi”, Rimini; 2 IRST, Meldola
Background and aim: Colorectal cancer is registered as the underlying cause of approximately 20,000 deaths in Italy every year. In our Region, Emilia Romagna, the incidence of colon cancer is 2.5 times more frequent then rectal cancer and in 2003 we registered 1,606 deaths (1,147 for colon cancer and 458 for the rectal one) due to colorectal cancer (11.5% of all tumors). In Rimini, in 2005, we registered 223 tumors of the colon and 94 rectal cancer. In 2005 in Rimini, we started the first Round of the Colorectal Cancer Screening Programme; we invited from March 2005 to March 2007, 75,464 individuals aged 50-69, offering FOBT (Faecal Occult Blood Testing) every two years (biennal screening), and in case of positive test we offered pancolonscopy as second level test. The aim of this study is the comparise of the histopathologic profile (TNM) of tumors diagnosis before the beginning of colorectal cancer screening programme (2003-2004) and those found in the first round of Screening. Material and methods: In this case-control study we considered “cases” all individuals with colorectal cancer consecutively diagnosed by Screening and “controls” the pre-screening diagnosed one. Cases and controlls were matched by sex and age with ratio 1:2. We enrolled 110 cases and 202 controlls, aged 50-69 years, registered in Rimini’s Hospital. The statistical analysis was performed with STATA 9.2 program. Results: Univariate analysis showed a significative difference between cases and controls (Pearson chi square test) for “T” - Tumor size in TNM definition - (p< 0.001) and Dukes stage (p<0.001). Instead we found a non significative difference for localization (colon vs rectum p>0.01): in cases colon cancer were about 3 times more frequent then rectum, in colntrols colon cancer were about 5 times more frequent then the rectum one. In the multivariate analysis (logistic regression analysis) we found a significative association for “T” and localization. Conclusions: We observed a significative difference in “T” and Dukes Stage between cases and controlls; this probably suggests that screening programme based on biennal FOBT, has an objective benefit in detecting tumors at early stage with obvious rebounds on the kind of surgery, chemotherapy and quality of life. We know that we need further studies and long follow up period to investigate differences in mortality and survival in the two groups. # J. GI Oncology 3. Screenings
PA.119 COLORECTAL CANCER SCREENING: ARE WE DOING ENOUGH? ONE YEAR SINGLE CENTER EXPERIENCE IN HIGH AND LOW RISK POPULATION G. Del Vecchio Blanco ∗ , M. Cretella, E. Mannisi, O.A. Paoluzi, E. Grasso, M. Giannelli, P. Sileri, A. Caruso, A. Alvino, R. Lionetti, L. Baiocchi, I. Stroppa, L. Biancone, D. Liotti, G. Palmieri, F. Pallone Università Tor Vergata, Roma Background and aim: Colorectal cancer (CRC) is the second most frequent cause of cancer-related death. CRC cancer arise in previously benign adenomatous polyps therefore their early detection and resection is the only methods to prevent cancer. Colonoscopy is accurate and cost-effectiveness to identify proximal asymptomatic advanced cancer in general population and in particular in patients with a family history of hereditary nonpolyposis colorectal cancer. Aim: This retrospective study was performed to evaluate the prevalence of polyps and CCR asymptomatic patients. Secondary we assess in our population the safety of colonscopy and the role of premedication in complete colonoscopy to the cecum. Material and methods: We retrospectively analyzed colonoscopy recorded from January 06 and October 07, to identify colonoscopy performed as screening test in high and average risk patients. The eligible population included asymptomatic subjects with family history of CRC (high risk group) aged >40yrs and asymptomatic subjects (average risk group) aged >50yrs. The database included age, gender, the indication for the exam (familiy history of CRC, positive FOBT or screening) the presence or absence of colonic polyps, and the histopathology of each polyp removed, kind of premedication, eventually complications and if colonoscopy was full or not. Results: Among 5535 colonoscopies, 533 (9,6%) were performed for CCR screening, 251/533 for family history of CRC (105 male, median age 53, range 41-78) and 282/533 for general screening (113 male, median age 61yrs, range 51-88). Colonoscopy was completed to the cecum in 464/533 subjects (87%) with no complications. 266 subjects had no sedation, 69 subjects had conscious sedation and 201 deep sedation. No polypoid lesions were found in 384 patients (72%). Among the other, polyps were found in 73/251 (29%) subjects in high risk patients and in 71/282 (25%) in average risk group. 153 polyps were removed: 45 hyperplastic polyps (29%), 91 tubular adenomas with low grade dysplasia (59%), 19 advanced disease (12%) (defined as an adenoma 10 mm or larger, or with villous features, moderate-to-severe dysplasia). In 6/533subjects (1.1%) we found invasive cancer. Conclusions: We confirm the usefulness of CRC screening by colonoscopy. Colonoscopy in our experience is a safe and well accepted. Therefore we suggest to improve multi centric screening programs using colonoscopy. # J. GI Oncology 3. Screenings
PA.120 STRATEGIES TO ENHANCE PARTICIPATION IN A SCREENING PROGRAM FOR COLORECTAL CANCER S. Crotta ∗ ,1 , B. Dagnes 1 , G. Grazzini 2 , C. Senore 3 1 Ospedale Beauregard, Aosta; 2 Istituto cientifico Prevenzione Oncologica CSPO, Firenze; 3 Centro Prevenzione Oncologica, Torino
Background and aim: Participation of target population is a critical point in a colorectal cancer screening program. Test type, delivery modalities or characteristics of population can influence the adhesion of invited people. Results from the Italian survey in 2005 showed that participation was about 47%(1). Material and methods: Between June 2006 and May 2007, 15,780 residents in Aosta Valley (M 7,964 F 7,816 aged 50-74) were invited by mail to perform a 1-day latex immunological FOBT (OC Sensor;
Abstracts / Digestive and Liver Disease 40S (2008), S1–S195
the importance of prevention in colorectal cancer, and suggests the best diagnostic procedure: colonoscopy. If the patient refuses to undergo this procedure we suggest barium enema or virtual TC. Results: In the biennium 2005-2007, 49749 people (26156 females and 23593 males) were invited to carry out FOBT test. Of these, 406 were excluded due to the fact that they had carried out either FOBT test or colonoscopy recently. 21432 people (43.4%) performed the test: 20149 (94.1%) negative and 1281 (5.9%) positive. Of those who tested positive for FOBT 1155 (91%) underwent a colonoscopy. Up until August 2007, 678 colonoscopies have been performed, with the following results: 62 adenocarcinomas stage Duke A (9.1%), 35 malignant polyps (5.1%), 251 high-grade adenomas (37%), 282 low-grade adenomas (41.5%), according to regional research criteria. Conclusions: An appropriate screening campaign allows for early diagnosis of colorectal cancer. The efficiency of the screening campaign depends on a high adhesion of those members of the community who are at risk. Good organization is of fundamental importance for a high participation in the screening campaign # J. GI Oncology 3. Screenings
PA.118 OBSERVATIONS AND RESULTS OF THE FIRST ROUND OF COLORECTAL CANCER SCREENING PROGRAMME IN RIMINI M. Giovanardi 1 , C. Casale 1 , C. Balducci 1 , I. Panzini 1 , O. Giuliani 2 , D. Canuti 1 , C. Fava 1 , F. Santilli 1 , M. Di Marco 1 , F. Desiderio 1 1 Ospedale
“Infermi”, Rimini; 2 IRST, Meldola
Background and aim: Colorectal cancer is registered as the underlying cause of approximately 20,000 deaths in Italy every year. In our Region, Emilia Romagna, the incidence of colon cancer is 2.5 times more frequent then rectal cancer and in 2003 we registered 1,606 deaths (1,147 for colon cancer and 458 for the rectal one) due to colorectal cancer (11.5% of all tumors). In Rimini, in 2005, we registered 223 tumors of the colon and 94 rectal cancer. In 2005 in Rimini, we started the first Round of the Colorectal Cancer Screening Programme; we invited from March 2005 to March 2007, 75,464 individuals aged 50-69, offering FOBT (Faecal Occult Blood Testing) every two years (biennal screening), and in case of positive test we offered pancolonscopy as second level test. The aim of this study is the comparise of the histopathologic profile (TNM) of tumors diagnosis before the beginning of colorectal cancer screening programme (2003-2004) and those found in the first round of Screening. Material and methods: In this case-control study we considered “cases” all individuals with colorectal cancer consecutively diagnosed by Screening and “controls” the pre-screening diagnosed one. Cases and controlls were matched by sex and age with ratio 1:2. We enrolled 110 cases and 202 controlls, aged 50-69 years, registered in Rimini’s Hospital. The statistical analysis was performed with STATA 9.2 program. Results: Univariate analysis showed a significative difference between cases and controls (Pearson chi square test) for “T” - Tumor size in TNM definition - (p< 0.001) and Dukes stage (p<0.001). Instead we found a non significative difference for localization (colon vs rectum p>0.01): in cases colon cancer were about 3 times more frequent then rectum, in colntrols colon cancer were about 5 times more frequent then the rectum one. In the multivariate analysis (logistic regression analysis) we found a significative association for “T” and localization. Conclusions: We observed a significative difference in “T” and Dukes Stage between cases and controlls; this probably suggests that screening programme based on biennal FOBT, has an objective benefit in detecting tumors at early stage with obvious rebounds on the kind of surgery, chemotherapy and quality of life. We know that we need further studies and long follow up period to investigate differences in mortality and survival in the two groups. # J. GI Oncology 3. Screenings
PA.119 COLORECTAL CANCER SCREENING: ARE WE DOING ENOUGH? ONE YEAR SINGLE CENTER EXPERIENCE IN HIGH AND LOW RISK POPULATION G. Del Vecchio Blanco ∗ , M. Cretella, E. Mannisi, O.A. Paoluzi, E. Grasso, M. Giannelli, P. Sileri, A. Caruso, A. Alvino, R. Lionetti, L. Baiocchi, I. Stroppa, L. Biancone, D. Liotti, G. Palmieri, F. Pallone Università Tor Vergata, Roma Background and aim: Colorectal cancer (CRC) is the second most frequent cause of cancer-related death. CRC cancer arise in previously benign adenomatous polyps therefore their early detection and resection is the only methods to prevent cancer. Colonoscopy is accurate and cost-effectiveness to identify proximal asymptomatic advanced cancer in general population and in particular in patients with a family history of hereditary nonpolyposis colorectal cancer. Aim: This retrospective study was performed to evaluate the prevalence of polyps and CCR asymptomatic patients. Secondary we assess in our population the safety of colonscopy and the role of premedication in complete colonoscopy to the cecum. Material and methods: We retrospectively analyzed colonoscopy recorded from January 06 and October 07, to identify colonoscopy performed as screening test in high and average risk patients. The eligible population included asymptomatic subjects with family history of CRC (high risk group) aged >40yrs and asymptomatic subjects (average risk group) aged >50yrs. The database included age, gender, the indication for the exam (familiy history of CRC, positive FOBT or screening) the presence or absence of colonic polyps, and the histopathology of each polyp removed, kind of premedication, eventually complications and if colonoscopy was full or not. Results: Among 5535 colonoscopies, 533 (9,6%) were performed for CCR screening, 251/533 for family history of CRC (105 male, median age 53, range 41-78) and 282/533 for general screening (113 male, median age 61yrs, range 51-88). Colonoscopy was completed to the cecum in 464/533 subjects (87%) with no complications. 266 subjects had no sedation, 69 subjects had conscious sedation and 201 deep sedation. No polypoid lesions were found in 384 patients (72%). Among the other, polyps were found in 73/251 (29%) subjects in high risk patients and in 71/282 (25%) in average risk group. 153 polyps were removed: 45 hyperplastic polyps (29%), 91 tubular adenomas with low grade dysplasia (59%), 19 advanced disease (12%) (defined as an adenoma 10 mm or larger, or with villous features, moderate-to-severe dysplasia). In 6/533subjects (1.1%) we found invasive cancer. Conclusions: We confirm the usefulness of CRC screening by colonoscopy. Colonoscopy in our experience is a safe and well accepted. Therefore we suggest to improve multi centric screening programs using colonoscopy. # J. GI Oncology 3. Screenings
PA.120 STRATEGIES TO ENHANCE PARTICIPATION IN A SCREENING PROGRAM FOR COLORECTAL CANCER S. Crotta ∗ ,1 , B. Dagnes 1 , G. Grazzini 2 , C. Senore 3 1 Ospedale Beauregard, Aosta; 2 Istituto cientifico Prevenzione Oncologica CSPO, Firenze; 3 Centro Prevenzione Oncologica, Torino
Background and aim: Participation of target population is a critical point in a colorectal cancer screening program. Test type, delivery modalities or characteristics of population can influence the adhesion of invited people. Results from the Italian survey in 2005 showed that participation was about 47%(1). Material and methods: Between June 2006 and May 2007, 15,780 residents in Aosta Valley (M 7,964 F 7,816 aged 50-74) were invited by mail to perform a 1-day latex immunological FOBT (OC Sensor;