Impacto de un programa de cribado poblacional basado en detección de sangre oculta en heces sobre el manejo quirúrgico del cáncer colorrectal / Impact of a population screening program based on fecal occult blood detection on the surgical management of colorectal cancer

RESUMEN

OBJETIVO PRINCIPAL comparar los pacientes intervenidos de CCR (Cáncer colorrectal) en el contexto de un programa de cribado poblacional versus aquellos diagnosticados por presentar síntomas. METODOLOGÍA: estudio longitudinal retrospectivo. Se estudiaron dos cohortes de pacientes intervenidos de CCR en el Hospital Clínico de Barcelona (2010-2012) procedentes del Programa de detección precoz de CCR de Barcelona (n = 59), y de Urgencias o de Consultas Externas por presentar sintomatología (n = 118). RESULTADOS PRINCIPALES Los del grupo cribado presentaron con mayor frecuencia tumores en estadio precoz (estadios I-II) que el grupo síntomas (57,6% vs 23,7%; p < 0,001). La necesidad de uso de ostomía, y la estancia hospitalaria fue superior en el grupo síntomas (36,4% vs 10,2%; p = 0,001; 10,1 días vs 7,1 días; p < 0,001. CONCLUSIÓN PRINCIPAL los pacientes con CCR diagnosticados en el contexto de programas de cribado presentan un estadio más precoz, menor estancia hospitalaria y menor necesidad de ostomías. El programa de cribado poblacional presenta beneficios para los pacientes y el sistema sanitario

ABSTRACT

OBJECTIVE: the comparison of patients diagnosed in a screening program versus those diagnosed by symptoms has not been studied in depth. The aim of this study is to compare patients diagnosed with CRC in the context of a population-based screening program and those diagnosed only by symptoms. METHODS: longitudinal retrospective study in which two cohorts of patients with CRC are compared between 2010 and 2012 at Hospital Clinic de Barcelona depending on the method of diagnosis. Fifty-nine patients diagnosed by the cancer screening programme of Barcelona were compared with 118 patients diagnosed only by symptoms at the emergency room or outpatient clinic. RESULTS: Patients in the screened group presented more frequently tumors in the early stage (stages I-II) compared with the symptom group (57.6% vs. 23.7%, p < 0.001). The need for ostomy was higher in the symptom group, (36, 4% vs 10,2%, p = 0.001). Hospital stay was higher in the group diagnosed only by symptoms (10.1 days vs 7.1 days, p < 0.001). CONCLUSIONS: Patients with CRC diagnosed in the context of screening programmes have an earlier stage, shorter hospital stay and less need for ostomy. In conclusion, the population screening program, beyond the reduction of delayed diagnosed and mortality, directly benefits CRC patients and decreases Hospital costs