Wolfson Unit for Endoscopy, St Mark's Hospital, Harrow, UK.
Colorectal Dis. 2012 Feb;14(2):166-73. doi: 10.1111/j.1463-1318.2011.02567.x.
St Mark's Bowel Cancer Screening Centre commenced screening in October 2006 as a contributor to the national programme. The first 35 months' experience is reported.
Individuals with a positive faecal occult blood test (FOBT) were offered colonoscopy or alternatives if they had significant comorbidity. All screening data were collected prospectively.
Of the 98 815 FOBT kits issued, 42 523 were returned (43% uptake; 20.79% men). In total, 1339/1488 (90%) FOBT-positive participants attended the nurse clinic (57% men). Of these, 1057 had an index colonoscopy, 115 had a computed tomography colonoscopy (CTC) and eight had a flexible sigmoidoscopy. Five hundred and seventeen (44%) procedures were 'normal' (no polyps/cancers). Eighty (6%) individuals had colorectal cancer. The polyp detection rate in index procedures, including colonoscopy, CTC and flexible sigmoidoscopy, was 50%. The adenoma detection rate of all colonoscopies was 62.8%. The median polyp size was 5 (1-80) mm. In total, 1200 colonoscopies were performed by five accredited colonoscopists (96% completion rate). There were 13 (1%) adverse events with < 1 in 500 patients undergoing polypectomy requiring a transfusion. There was one 30-day postsurgical mortality, one perforation and no colonoscopy-related mortality. Almost all 39/40 (97%) patients in the BCS programme felt that the findings were adequately explained compared with 21/32 (64%) elective patients (P < 0.001) within the same unit.
At this bowel cancer screening single centre, colonoscopy completion rates were high (unadjusted caecal intubation rate of 96%) and complication rates were low. In contrast to other published data, the uptake and cancer-detection rates were lower.
圣马克肠道癌症筛查中心于 2006 年 10 月开始作为国家项目的一部分进行筛查。现报道前 35 个月的经验。
粪便潜血试验（FOBT）阳性的个体如果有明显的合并症，则接受结肠镜检查或其他替代检查。所有筛查数据均前瞻性收集。
在发放的 98815 份 FOBT 试剂盒中，有 42523 份被退回（43%的参与率；男性占 20.79%）。总的来说，1339/1488（90%）FOBT 阳性参与者参加了护士诊所（57%为男性）。其中，1057 人进行了指数结肠镜检查，115 人进行了计算机断层扫描结肠镜检查（CTC），8 人进行了柔性乙状结肠镜检查。517 人（44%）的检查结果为“正常”（无息肉/癌症）。80 人（6%）患有结直肠癌。指数检查（包括结肠镜检查、CTC 和柔性乙状结肠镜检查）中息肉的检出率为 50%。所有结肠镜检查的腺瘤检出率为 62.8%。息肉的中位大小为 5（1-80）mm。共有 5 名认证的结肠镜检查医师进行了 1200 例结肠镜检查（完成率为 96%）。有 13 例（1%）不良事件，每 500 例接受息肉切除术的患者中就有 1 例需要输血。有 1 例 30 天术后死亡，1 例穿孔，无结肠镜相关死亡。在 BCS 项目中，几乎所有 39/40（97%）的患者都认为检查结果得到了充分的解释，而同一单位的 32/32（64%）择期患者则认为检查结果得到了充分的解释（P<0.001）。
在这个肠道癌症筛查的单一中心，结肠镜检查的完成率很高（未调整的盲肠插管率为 96%），并发症发生率很低。与其他已发表的数据相比，参与率和癌症检出率较低。
