[Detection of polyps, adenomas, advanced adenomas and adenocarcinomas in patients between 45 and 49 years]. / Detección de pólipos, adenomas, adenomas avanzados y adenocarcinomas de colon en pacientes entre 45 y 49 años.

UNLABELLED: BACKGROUND. Colorectal cancer (CRC) can be prevented. Colonoscopy is the first-line procedure for screening in average risk population. In 2002, Imperiale evaluated people between 40 to 49 years and reported that adenomas and advanced adenomas presented in 8.5% and 3.5% of cases, respectively. Currently, no recommendations for CRC screening in this population have been made. OBJECTIVE: To estimate the prevalence ofpolyps, adenomas, advanced lesions and adenocarcinomas in the 45- to 49-year-old population. METHODS: We included consecutive adults between 45 and 49 years old who performed colonoscopy because of gastrointestinal signs or symptoms. Exclusion criteria were high risk for CRC, incomplete VCC and/or previous evidence of colonic lesions. The study was conducted in a gastroenterology center from Buenos Aires, between September 2010 and October 2011. The design was prospective and cross-sectional. Polyethylene glycol (PEG) lavage solution or phosphates were usedfor cleansing. Colonoscopies were performed under sedation with Olympus equipment. The protocol was approved by the local IRB. 95% confidence intervals (95% CI) were estimated. RESULTS: 814 patients were evaluated and 764 were included, 440 (57%) were women and the average age was 47 years. The global prevalence of polyps was 20% (160 cases, 95% CI 18%-24%). The global prevalence of adenomas was 14% (107 cases, 95% CI 11%-16%). The prevalence of advanced adenomas was 5% (39 cases, 95% CI 4%-7%) and the prevalence of adenocarcinoma was 0.1% (1 case, 95% CI 0%-0.7%). CONCLUSIONS: The prevalence of lesions in this population is lower than that in the average risk population. At the moment we do understand that there is no evidence to recommend CRC screening in 45- to 49-year-old individuals.

[Contributions of endoscopic ultrasound to pancreatic cystic lesions]. / Aportes de la ecografía endoscópica a las lesiones quísticas del páncreas.

Cystic lesions of the pancreas are peculiar in relation to their diagnosis and treatment. The use of endoscopic ultrasonography (EUS) has provided better sensitivity and specificity to differentiate benign from malignant cysts, condition that provides an early diagnosis and an effective and definite treatment.

[Adherence of physicians to colorectal cancer screening: which is their compliance to this strategy?]. / Adherencia de la población médica a los programas de rastreo de cáncer colorrectal: ¿Cuál es el cumplimiento de esta medida preventiva entre los profesionales?

BACKGROUND: Colorectal cancer (CRC) screening is strongly recommended as early diagnosis improves survival and reduces mortality. However, the adherence in general population is about 50% and even lower among physicians. OBJECTIVE: 1) To estimate the percentage of physicians that had done a screening test. 2) To estimate the frequency of tests used by these professionals. METHODS: We conducted an anonymous survey among 269 physicians, 50-year-old or more, from four hospitals and four scientific conventions in 2008. This validated survey included specialty, family history, compliance to screening, clinical features at screening, age, tests used reasons for having or not done the tests and results. RESULTS: Twenty-four hundred and two data surveys were included (response rate 90%). Average age was 58+6 years. Specialties were Internal Medicine (72%), Surgery (18%) and others (9%). One hundred physicians had a test done [41% (IC95% 35-47)]. The most used test was colonoscopy [70% (IC 95% 60-78)], followed by barium enema [10% (IC 95% 5-18)]. From screened physicians, 36% had family history of CRC, 63% did not and 1% was unaware of this antecedent. Physicians referred the following reasons for not being compliant: personal decision, fear of the procedure, insufficient knowledge of guidelines and lack of time. CONCLUSIONS: The compliance of physicians to CRC screening is suboptimal. New strategies should be implemented to achieve changes in health habits of physicians and compliance to preventive strategies.

Aportes de la ecografía endoscópica a las lesiones quísticas del páncreas / [Contributions of endoscopic ultrasound to pancreatic cystic lesions].

Cystic lesions of the pancreas are peculiar in relation to their diagnosis and treatment. The use of endoscopic ultrasonography (EUS) has provided better sensitivity and specificity to differentiate benign from malignant cysts, condition that provides an early diagnosis and an effective and definite treatment.