615 Searching For The Best Way Of Colorectal Cancer Screening

Kral N, Seifert B
Czech Republic
Aims: Many countries have national screening programme for colorectal cancer (CRCA) for a long time, but adherence of population to screening programme is low and the results are not satisfying. In 2009 the Czech Republic took steps to improve the screening. The population start with the screening with faecal occult blood test (FOBT) based periodically from the age of 50. At the age of 55 they can choose between FOBT based periodically and Primary screening colonoscopy (PSC) in the interval of 10 years. Before the change of the screening the most popular test was guajac FOBT (gFOBT), now is it generally immunochemical FOBT (iFOBT). In order to know the sensitivity a specificity of iFOBT and the number of false negative results we prepared the survey.
Material and methods: We collected data about all iFOBT performed by selected GPs (20). Using a previously validated self-completion questionnaire we undertook a postal survey of selected GPs.
Results: 20 GPs performed 1203 iFOBT. Among the participants there were 821 (67, 6%) women and 383 (31, 6%) men. The number of positive tests was 93, the number of negative tests was 1110. In the case of positive FOBT the screening colonoscopy follows. 47 (50, 5%) persons with positive iFOBT were without medical findings or they had haemorrhoids. 28 (30, 1%) persons with positive test had polyp or advanced adenoma. The CRCA was discovered in 6 cases (6, 5%). We didn't receive result of colonoscopy from 6 patients. Waiting time between positive test and follow up screening colonoscopy was 30 days.
Conclusion: The obtained data show that the sensitivity and specificity of iFOBTs are adequate. In comparison with the data from the national registry, which do not distinguish between the iFOBT and gFOBT, in our study iFOBT have approximately the same detection of polyps and advanced adenomas, but higher detection of CRCA.
Searching for the best way of colorectal cancer screening