Keller R, Schätzle A, Flieger D, Christl S U, Fischbach W
Medizinische Klinik II, Klinikum Aschaffenburg.
Z Gastroenterol. 2003 Jul;41(7):655-8. doi: 10.1055/s-2003-40544.
Colorectal cancer (CRC) is a leading cause of illness and death in the Western world. Screening with fecal occult blood test (FOBT) significantly reduces the death rate and the incidence from CRC but these tests are not widely accepted. We investigated the possible contribution of hospitalization to a better acceptance of CRC screening.
From October 1998 through September 2000, 721 consecutive patients between 45 and 75 years of age admitted for various reasons were asked for participation in the study. They were asked to participate in FOBT-screening. In case of refusal of FOBT they were asked a second time after detailed information. In patients who accepted 3 consecutive FOBT's were performed. In case of positive FOBT results colonoscopy and gastroscopy were performed.
149 (82 male/67 female) patients were included. 94 (63.5%) of them agreed to undergo FOBT primarily and 10 (6.8%) secondarily after detailed information. The total acceptance rate of the FOBT was 69.8% (m/w : 69.1%/71.6%). In one of 5 cases with a positive FOBT result colorectal cancer (CRC) was diagnosed. Information on repetition of FOBT after one year could be obtained from 82 patients (55%). 37 patients (45%) had undergone repeated FOBT. None of the 37 patients was motivated by the FOBT screening during hospitalization.
Staying in a hospital offers a good chance to achieve a higher acceptance of the FOBT. Therefore, hospitalization may contribute to a better colorectal cancer prevention. However, motivation to regularly repeat screening does not last in all patients. Therefore, public campaigns as well as medical counseling need to continuously stress the necessity of CRC screening procedures.
在西方世界，结直肠癌（CRC）是导致疾病和死亡的主要原因之一。粪便潜血试验（FOBT）筛查可显著降低结直肠癌的死亡率和发病率，但这些检测方法并未被广泛接受。我们研究了住院治疗对更好地接受CRC筛查的可能作用。
从1998年10月至2000年9月，连续纳入721例因各种原因入院的45至75岁患者参与本研究。邀请他们参加FOBT筛查。若拒绝FOBT，在提供详细信息后再次邀请。接受筛查的患者连续进行3次FOBT检测。若FOBT结果为阳性，则进行结肠镜检查和胃镜检查。
纳入149例患者（82例男性/67例女性）。其中94例（63.5%）最初同意接受FOBT检测，10例（6.8%）在了解详细信息后同意接受检测。FOBT的总接受率为69.8%（男/女：69.1%/71.6%）。在FOBT结果阳性的5例患者中，有1例被诊断为结直肠癌（CRC）。82例患者（55%）提供了一年后FOBT复查的信息。37例患者（45%）进行了FOBT复查。37例患者中没有一例是因住院期间的FOBT筛查而产生复查意愿的。
住院为提高对FOBT的接受度提供了良好机会。因此，住院治疗可能有助于更好地预防结直肠癌。然而，并非所有患者都有定期复查筛查的意愿。因此，公共宣传活动以及医疗咨询需要持续强调CRC筛查程序的必要性。
