Federici A, Valle S, Giorgi Rossi P, Grassi A, Borgia P, Guasticchi G
Agenzia di Sanità Pubblica della Regione Lazio, Roma.
Ann Ig. 2006 May-Jun;18(3):215-24.
The aim of the present work is to describe the characteristics of digestive endoscopy centers and the physicians that work there, with particular attention to their attitudes and practices in colorectal cancer screening. A questionnaire was sent to all 80 digestive endoscopy centers in the Lazio region, identified by the annual census of Italian Society of Digestive Endoscopy (Società Italiana di Endoscopia Digestiva, SIED). Seventy-one centers (89%), returned the questionnaire. Screening activity on average represents 14% of the centers' colonoscopy workload. Colonoscopy was considered to be a "very effective" screening test by 96% of physicians, the faecal occult blood test "very effective" by 20%, and flexosigmoidoscopy "very effective" by 11%. Ninety-seven percent (97%) of physicians reported recommending any test for screening: 80% colonoscopy, 61% faecal occult blood test, 14% double contrast barium enema and 11% flexosigmoidoscopy. Despite the fact that almost all physicians reported recommending screening, the centres are only marginally involved in screening practice. Endoscopy centers' physicians tend to have an aggressive strategy for colorectal cancer prevention and exclusive trust in colonoscopy; an attitude more consistent with a clinical-diagnostic approach than with real mass screening of a healthy population.
本研究的目的是描述消化内镜中心及其工作人员的特点，尤其关注他们在结直肠癌筛查中的态度和做法。向拉齐奥地区所有80个消化内镜中心发送了一份调查问卷，这些中心由意大利消化内镜学会（Società Italiana di Endoscopia Digestiva, SIED）的年度普查确定。71个中心（89%）回复了问卷。筛查活动平均占这些中心结肠镜检查工作量的14%。96%的医生认为结肠镜检查是“非常有效的”筛查测试，20%的医生认为粪便潜血试验“非常有效”，11%的医生认为乙状结肠镜检查“非常有效”。97%的医生报告推荐任何筛查测试：80%推荐结肠镜检查，61%推荐粪便潜血试验，14%推荐双重对比钡灌肠，11%推荐乙状结肠镜检查。尽管几乎所有医生都报告推荐筛查，但这些中心仅在一定程度上参与筛查实践。内镜中心的医生倾向于采取积极的结直肠癌预防策略，并对结肠镜检查完全信任；这种态度更符合临床诊断方法，而不是对健康人群进行真正的大规模筛查。
