Departamento de Gastroenterología, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, México.
Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Mexico City, Mexico.
Fam Pract. 2020 Jul 23;37(3):321-324. doi: 10.1093/fampra/cmz078.
In middle-income countries, the burden of colorectal cancer (CRC) is increasing in parallel with resources for diagnosis and treatment. There is a potential benefit of CRC screening programs in Mexico.
Since there are no organized screening programs in the country, we explored the willingness of individuals to complete a faecal immunochemical testing (FIT) based CRC screening program and its potential benefit in Mexico.
We conducted a CRC screening program pilot in Veracruz, Mexico, during 2015-16 using FIT. Individuals with FIT results >100 ng of haemoglobin/ml buffer were referred for diagnostic colonoscopy.
Of 473 FIT kits distributed to adults aged 50-75, 85.8% (406) were completed by participants and analysed in the laboratory. Of these, 5.9% (24/406) of test results showed >100 ng haemoglobin/ml. Twenty-one participants completed colonoscopy. The positive predictive value of FIT >100 ng haemoglobin/ml for premalignant lesions was 33%.
These results provide preliminary evidence of the willingness of individuals to complete FIT-based CRC screening program in Mexico. However, further evaluation of health systems resources will be needed prior to large-scale implementation of CRC screening programs.
在中等收入国家，结直肠癌（CRC）的负担与诊断和治疗资源同步增加。墨西哥有开展 CRC 筛查计划的潜在获益。
由于该国没有组织化的筛查计划，我们探讨了个体完成基于粪便免疫化学检测（FIT）的 CRC 筛查计划的意愿及其在墨西哥的潜在获益。
我们在 2015-2016 年期间在墨西哥韦拉克鲁斯州开展了 CRC 筛查计划试点，使用 FIT 进行筛查。FIT 结果 >100ng 血红蛋白/ml 缓冲液的个体被转诊进行诊断性结肠镜检查。
在分配给 50-75 岁成年人的 473 个 FIT 试剂盒中，有 85.8%（406）由参与者完成并在实验室进行了分析。其中，5.9%（24/406）的检测结果显示 >100ng 血红蛋白/ml。21 名参与者完成了结肠镜检查。FIT >100ng 血红蛋白/ml 对癌前病变的阳性预测值为 33%。
这些结果初步证明了个体在墨西哥完成基于 FIT 的 CRC 筛查计划的意愿。然而，在大规模实施 CRC 筛查计划之前，需要进一步评估卫生系统资源。
