Pezzoli A, Matarese V, Rubini M, Simoni M, Caravelli G C, Stockbrugger R, Cifalà V, Boccia S, Feo C, Simone L, Trevisani L, Liboni A, Gullini S
Department of Gastroenterology and GI Endoscopy, University Hospital, Ferrara, Italy.
Dig Liver Dis. 2007 Jan;39(1):33-9. doi: 10.1016/j.dld.2006.09.001. Epub 2006 Oct 16.
The province of Ferrara has one of the highest incidences of colorectal cancer (CRC) in Italy. In January 2000, we set up a colonoscopy screening program focussing on first-degree relatives of CRC patients. We now report the results 5 years after the beginning of the project. SCREENEES AND METHODS: In October 1999, we started a campaign stressing the usefulness of colonoscopy for the first-degree relatives of CRC patients. Subjects included in the screening program were aged between 45 and 75 years with at least one first-degree relative affected by CRC. They were invited to an interview where a physician suggested colonoscopy as a screening option.
In 5 years, 776 subjects were interviewed and 733 (94.4%) agreed to an endoscopic examination (M/F:375/401; mean age 55 years): 562 colonoscopies were performed. Adenomas and cancers were found in 122 (21.7%) and 12 (2.1%) subjects, respectively. Histological examination in 181 persons with lesions (32.8%) showed (most serious lesion quoted) 47 hyperplastic polyps (26% of all lesions), 2 serrated adenomas (1.1%), 68 tubular adenomas (48%), 24 tubulovillous adenomas (13.3%), 9 adenomas with high grade dysplasia (5%) and 12 adenocarcinomas (6.6%). The majority of the cancers were at an early stage (8 Dukes A and 3 Dukes B). Sedation was used in only 42 colonoscopies (7.5%).
A colonoscopy-based screening in this selected high-risk population is feasible. Even without sedation subjects readily agreed to the endoscopic procedure. We identified a significant number of advanced neoplasms and cancers at an early stage suggesting that this could be a useful tool in early identification of CRC.
费拉拉省是意大利结直肠癌（CRC）发病率最高的地区之一。2000年1月，我们开展了一项结肠镜筛查项目，重点关注CRC患者的一级亲属。现在我们报告该项目启动5年后的结果。
1999年10月，我们开展了一项活动，强调结肠镜检查对CRC患者一级亲属的有用性。纳入筛查项目的对象年龄在45至75岁之间，至少有一位受CRC影响的一级亲属。他们被邀请参加一次访谈，医生在访谈中建议将结肠镜检查作为一种筛查选择。
5年间，共访谈了776名对象，其中733名（94.4%）同意接受内镜检查（男/女：375/401；平均年龄55岁）：共进行了562例结肠镜检查。分别在122名（21.7%）和12名（2.1%）对象中发现了腺瘤和癌症。对181名有病变的人（32.8%）进行的组织学检查显示（引用最严重的病变）47例增生性息肉（占所有病变的26%）、2例锯齿状腺瘤（1.1%）、68例管状腺瘤（48%）、24例绒毛状管状腺瘤（13.3%）、9例高级别异型增生腺瘤（5%）和12例腺癌（6.6%）。大多数癌症处于早期阶段（8例杜克A期和3例杜克B期）。仅42例结肠镜检查（7.5%）使用了镇静剂。
在这个选定 的高风险人群中，基于结肠镜检查的筛查是可行的。即使不使用镇静剂，对象也很容易同意接受内镜检查。我们在早期发现了大量晚期肿瘤和癌症，这表明这可能是早期识别CRC的有用工具。
