RESUMO
Objetivo: Describir los resultados de la implantación del programa piloto, en la comunidad de Castilla y León, del cribado de cáncer colorrectal (CCR) mediante la detección de sangre oculta en heces utilizando una prueba inmunológica cuantitativa de aglutinación en látex (TSOHi). Métodos: Población diana de 4.930 personas entre 50-69 anos de la zona básica de salud de Medina del Campo. A los que presentaron TSOHi positivo se les realizó colonoscopia. Se calcularon tasas de participación, positividad, aceptación de colonoscopia, detección de lesiones, porcentajes y valor predictivo positivo (VPP) de la prueba. Resultados: La tasa de participación fue de 2.241 personas (46.33%). Los TSOHi positivos fueron 138 (6,15%). La tasa de aceptación de la colonoscopia fue del 99,27%. Se detectaron 12 pacientes con CCR (el 91,66% en estadios precoces), 42 con adenoma de alto riesgo (AAR) y 34 con adenoma de bajo riesgo (ABR). Las tasas de detección fueron para el CCR de 5,35, para el AAR de 18,74, para el ABR de 15,17 y del 39,26 para todo tipo de adenoma. El VPP fue del 8,69% para el CCR, del 30,43% para el AAR y del 24,63% para el ABR. Conclusiones: El programa de detección de CCR es factible en nuestro contexto. Los indicadores del TSOHi son superiores a los de otros estudios realizados con pruebas clásicas. Las altas tasas de detección de CCR y de todo tipo de adenoma justificarían por sí solas el estudio. Estas, junto con la precocidad del diagnóstico de CCR, harían posible anticipar una reducción de la mortalidad (AU)
Objective: To describe the results of implementing a pilot screening program, in the Castilla y León, for colorectal cancer (CRC) with the faecal occult blood test (iFOBT) using a quantitative immunological latex agglutination assay. Methods: The study population included 4930 persons between 50-69 years from the Basic Health Area of Medina del Campo. Colonoscopy was performed on those who had a positive iFOBT. The rates of participation were calculated, positivity, acceptance of colonoscopy, detection of lesions, percentages and predictive positive value (PPV) of the test. Results: A total of 2241 (46.33%) people took part. There were 138 (6.15%) positive iFOBT. The rate acceptance of the colonoscopy was 99.27%. CRC was detected in 12 patients (91.66% in early stages), a high risk adenoma (HRA) in 42, and a low risk adenoma (LRA) in 34. The rates of detection were for CRCwas 5.35, 18.74 for HRA, 15.17 for LRA, and 39.26 for all kinds of adenoma. The PPV was 8.69% for CCR, 30.43% for HRA and 24.63% for LRA. Conclusions: The CRC screening program is feasible in our context. The iFOBT indicators are superior to those of other studies performed using the classic test. The high rates of detection of CRC, and all kinds of adenoma would be enough to justify the study. These together with the diagnosis of CRC in the early stages could lead to a reduction of the mortality (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/imunologia , Diagnóstico Precoce , Testes Imunológicos/instrumentação , Testes Imunológicos/métodos , Testes Imunológicos , Valor Preditivo dos Testes , Sangue Oculto , Colonoscopia/métodos , Programas de Rastreamento/métodos , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/prevenção & controle , População Urbana/tendências , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde , Testes Imunológicos/tendênciasRESUMO
OBJECTIVE: To describe the results of implementing a pilot screening program, in the Castilla y León, for colorectal cancer (CRC) with the faecal occult blood test (iFOBT) using a quantitative immunological latex agglutination assay. METHODS: The study population included 4930 persons between 50-69 years from the Basic Health Area of Medina del Campo. Colonoscopy was performed on those who had a positive iFOBT. The rates of participation were calculated, positivity, acceptance of colonoscopy, detection of lesions, percentages and predictive positive value (PPV) of the test. RESULTS: A total of 2241 (46.33%) people took part. There were 138 (6.15%) positive iFOBT. The rate acceptance of the colonoscopy was 99.27%. CRC was detected in 12 patients (91.66% in early stages), a high risk adenoma (HRA) in 42, and a low risk adenoma (LRA) in 34. The rates of detection were for CRCwas 5.35, 18.74 for HRA, 15.17 for LRA, and 39.26 for all kinds of adenoma. The PPV was 8.69% for CCR, 30.43% for HRA and 24.63% for LRA. CONCLUSIONS: The CRC screening program is feasible in our context. The iFOBT indicators are superior to those of other studies performed using the classic test. The high rates of detection of CRC, and all kinds of adenoma would be enough to justify the study. These together with the diagnosis of CRC in the early stages could lead to a reduction of the mortality.
