Chew M H, Suzanah N, Ho K S, Lim J F, Ooi B S, Tang C L, Eu K W
Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore.
Singapore Med J. 2009 Apr;50(4):348-53.
Colorectal cancer (CRC) is a leading cause of morbidity and mortality with human and financial costs. Screening by faecal occult blood test (FOBT) has proven to be effective in decreasing mortality from CRC in both randomised trials and case-control studies. We report on the results of a CRC screening event using quantitative FOBT (QFOBT) held in Singapore.
The mass screening event was held over two days, and participants 40 years or older without prior screening performed in the preceding year were eligible. Those with significant symptoms or medical comorbidities were excluded. Stool sampling was done with two issued immunochemical QFOBT kits, and participants with positive stool samples with equal or greater than 100 ng haemoglobin/ml sample solution in any two samples were advised to have a colonoscopy screening conducted.
A total of 1,048 participants took part in the screening event. 222 (21 percent) of the participants claimed to have some abdominal symptoms prior to screening. 49 participants (26 males, 23 females) tested positive for QFOBT and 47 were evaluated. 10 (21 percent) had polyps and one case of colorectal cancer was detected. Seven of these cases had significant neoplasia (lesions 1 cm or larger) and were treated. Two patients required surgery.
Our study demonstrates wide variation in the attitudes of participants who turned up for screening. In addition, the number of significant colorectal neoplasia patients (14 percent) in those with positive QFOBT provides further evidence of the importance of screening with a potential reduction in CRC mortality. Continuous education of the public in events such as this, is essential to improving attitudes towards screening.
结直肠癌(CRC)是发病和死亡的主要原因,会带来人力和财力成本。在随机试验和病例对照研究中,粪便潜血试验(FOBT)筛查已被证明能有效降低结直肠癌死亡率。我们报告了在新加坡举行的一次使用定量粪便潜血试验(QFOBT)进行的结直肠癌筛查活动的结果。
大规模筛查活动持续两天,40岁及以上且前一年未进行过筛查的参与者有资格参加。有明显症状或合并症的患者被排除在外。使用两个发放的免疫化学QFOBT试剂盒进行粪便采样,任何两个样本中血红蛋白浓度等于或大于100 ng/ml样本溶液的粪便样本呈阳性的参与者被建议进行结肠镜筛查。
共有1048名参与者参加了筛查活动。222名(21%)参与者声称在筛查前有一些腹部症状。49名参与者(26名男性,23名女性)QFOBT检测呈阳性,其中47人接受了评估。10人(21%)有息肉,检测出1例结直肠癌。其中7例有显著的肿瘤(病变1厘米或更大)并接受了治疗。两名患者需要手术。
我们的研究表明,前来参加筛查的参与者态度差异很大。此外,QFOBT呈阳性者中显著结直肠肿瘤患者的比例(14%)进一步证明了筛查的重要性,有可能降低结直肠癌死亡率。在这样的活动中持续对公众进行教育,对于改善对筛查的态度至关重要。