Parente F, Marino B, DeVecchi N, Moretti R, Ucci G, Tricomi P, Armellino A, Redaelli L, Bargiggia S, Cristofori E, Masala E, Tortorella F, Gattinoni A, Odinolfi F, Pirola M E
Gastrointestinal Unit, Alessandro Manzoni Hospital, Lecco, Italy.
Br J Surg. 2009 May;96(5):533-40. doi: 10.1002/bjs.6568.
The results of a pilot colorectal cancer screening programme by biennial immunochemical faecal occult blood test (FOBT) are reported.
All residents aged between 50 and 69 years in the Italian province of Lecco were invited to have a FOBT. Those with a positive result were offered colonoscopy. FOBT uptake and compliance with colonoscopy were assessed. Detection rate and positive predictive value (PPV) for cancer and adenoma were calculated. Tumour stages were compared between screen-detected cancers and other colorectal cancers diagnosed within the target age group.
Some 38,693 (49.6 per cent) of 78,083 individuals had a FOBT and 2392 (6.2 per cent) had a positive result. Colorectal cancer was diagnosed in 4.6 per cent and advanced adenoma in 32.7 per cent. PPVs were 4.0 per cent for cancer, 28.1 per cent for advanced adenoma and 36.6 per cent for any adenoma. There was a significant difference in incidence of stage III/IV disease between screened and non-screened cohorts. Compliance for colonoscopy was 92.0 per cent. Major determinants of compliance were age less than 59 years, female sex, high education level and non-manual work.
These results justify extension of colorectal cancer screening to other regions of Italy.
报告了一项通过每两年进行一次免疫化学粪便潜血试验（FOBT）的结直肠癌筛查试点项目的结果。
邀请意大利莱科省所有年龄在50至69岁之间的居民进行FOBT检测。对检测结果呈阳性者进行结肠镜检查。评估FOBT的接受率和结肠镜检查的依从性。计算癌症和腺瘤的检出率及阳性预测值（PPV）。比较筛查发现的癌症与目标年龄组内诊断出的其他结直肠癌的肿瘤分期。
在78083名个体中，约38693人（49.6%）进行了FOBT检测，其中2392人（6.2%）检测结果呈阳性。诊断出结直肠癌的比例为4.6%，进展期腺瘤的比例为32.7%。癌症的PPV为4.0%，进展期腺瘤的PPV为28.1%，任何腺瘤的PPV为36.6%。筛查组和未筛查组之间III/IV期疾病的发病率存在显著差异。结肠镜检查的依从性为92.0%。依从性的主要决定因素是年龄小于59岁、女性、高学历和非体力工作。
这些结果证明将结直肠癌筛查扩展到意大利其他地区是合理的。
