免疫化学粪便潜血检测用于保加利亚结直肠癌筛查的可行性

Feasibility of immunochemical faecal occult blood testing for colorectal cancer screening in Bulgaria.

作者信息

Tsvetanova Dimova Rositsa, Dimitrova Dimitrova Donka, Angelova Levterova Boriana, Stoyanov Dimov Rossen, Atanasova Semerdjieva Maria, Frantova Tarnovska Miglena, Gencheva Stoyanova Rumiana

机构信息

Department of the Health Management, Health Economics and Primary Care, Faculty of Public Health, Medical University of Plovdiv, 15a V. Aprilov Blvd, Plovdiv, Bulgaria.

出版信息

J BUON. 2015 Mar-Apr;20(2):413-20.

PMID:26011330

Abstract

PURPOSE

Colorectal carcinoma (CRC) is the second most common cancer in Europe. Screening guidelines recommend a range of screening options that include faecal occult blood tests (FOBTs). The efficacy of FOBT-based CRC screening is dependent on the participation rate, thus emphasizing the importance of the latter. This study aimed at analysing the feasibility of CRC screening with immunochemical FOBT (iFOBT).

METHODS

A cross-sectional study of 600 asymptomatic persons at average risk, aged ≥45years from urban and rural municipalities was performed. An educational brochure, iFOBT kit with translated colored leaflet, informed consent form and questionnaire were administered to participants by 30 general practitioners. Faecal samples were analysed for occult blood using point-of-care rapid iFOBT (cut off 10 ng(GPs)Hb/ml) by the patients themselves at home. The questionnaire aimed to establish if they encountered difficulties in self-testing and self-analysing. Direct and indirect measures of test feasibility were used difficulties for reported study participation rate.

RESULTS

The participation rate was 78.8% (473 participants). Patients < 65 years (x² =70.8, Р<0.001), those with lower education level (x² =82.1, p<0.001), and patients living in villages (x² =4.3, p<0.05) reported difficulties more frequently and they needed help for self-testing by iFOBT. Positive test was found in 8.5% of all participants. Of them 19 persons (48.7%) had haemorrhoids, 8 (20.0%) benign neoplasms, and 3 (7.5%) had CRC.

CONCLUSIONS

CRC screening study by means of iFOBT as a point-of-care test proved to be feasible, since a high participation rate was obtained.

摘要

目的

结直肠癌（CRC）是欧洲第二常见的癌症。筛查指南推荐了一系列筛查选项，包括粪便潜血试验（FOBTs）。基于FOBT的CRC筛查的有效性取决于参与率，因此凸显了参与率的重要性。本研究旨在分析免疫化学粪便潜血试验（iFOBT）用于CRC筛查的可行性。

方法

对来自城乡社区的600名年龄≥45岁、平均风险的无症状人群进行了一项横断面研究。30名全科医生向参与者发放了一份教育手册、带有翻译彩色传单的iFOBT试剂盒、知情同意书和问卷。粪便样本由患者在家中使用即时检验快速iFOBT（临界值10 ng（全科医生）血红蛋白/毫升）进行潜血分析。该问卷旨在确定他们在自我检测和自我分析中是否遇到困难。使用报告的研究参与率的困难程度作为检测可行性的直接和间接衡量指标。

结果

参与率为78.8%（473名参与者）。年龄<65岁的患者（χ²=70.8，P<0.001）、教育水平较低的患者（χ²=82.1，p<0.001）以及居住在农村的患者（χ²=4.3，p<0.05）报告困难的频率更高，他们需要iFOBT自我检测的帮助。在所有参与者中，8.5%的检测呈阳性。其中19人（48.7%）患有痔疮，8人（20.0%）患有良性肿瘤，3人（7.5%）患有CRC。