TY - JOUR
T1 - Colonoscopic surveillance of first-degree relatives of colorectal cancer patients in a faecal occult blood screening programme
AU - Sassoli de Bianchi, Priscilla
AU - Campari, Cinzia
AU - Mancini, Silvia
AU - Giuliani, Orietta
AU - Landi, Patrizia
AU - Paterlini, Luisa
AU - Naldoni, Carlo
AU - Finarelli, Alba C.
AU - Falcini, Fabio
AU - Ponz de Leon, Maurizio
AU - Sassatelli, Romano
AU - Borciani, Elisabetta
AU - Fornari, Fabio
AU - Gatti, Giorgio
AU - Zatelli, Marella
AU - Zurlini, Corrado
AU - Rossi, Federica
AU - Corradini, Rossella
AU - Olivetti, Rossella
AU - Manfredi, Marilena
AU - Baldazzi, Paola
AU - Nannini, Roberto
AU - Zanarini, Stefano
AU - Matarese, Vincenzo G.
AU - Palmonari, Caterina
AU - Triossi, Omero
AU - Gordini, Sonia
AU - Vattiato, Rosa
AU - Colamartini, Americo
AU - Palazzi, Mauro
AU - Severi, Mirna
AU - Briganti, Laura
AU - Giovanardi, Mauro
AU - Casale, Coralba
AU - Bucchi, Lauro
PY - 2013/8
Y1 - 2013/8
N2 - Background: In some Italian areas, colonoscopic surveillance of first-degree relatives (FDRs) of colorectal cancer (CRC) patients is provided as a part of local population-based faecal occult blood test (FOBT) screening programmes. The objective of the present study was to assess the feasibility and early results of this surveillance model. Methods: Data from district screening centres were used to evaluate the process of identification and selection of eligible FDRs (residence in the Emilia-Romagna Region, age 40-75 years, no recent colonoscopy) of screen-detected CRC patients and the detected prevalence of disease. The probability for an FDR to undergo colonoscopy and to be diagnosed with CRC and advanced adenoma was estimated using the Kaplan-Meier method. The sex- and age-standardised ratio of detected prevalence to that expected based on results from a colonoscopy screening study of the Italian general population was estimated. Results: Between 2005 and 2011, 9319 FDRs of 2437 screen-detected CRC patients (3.8 per patient) were identified and contacted. Their likelihood of being eligible for, and accepting, colonoscopy was 0.11 (95% confidence interval: 0.11-0.12). Among the 926 subjects undergoing colonoscopy, the prevalence of previous negative screening FOBT was 63%. Eleven CRCs (1.2%) and 100 advanced adenomas (10.8%) were detected. The standardised ratio of detected prevalence to that expected was 0.91 (95% confidence interval: 0.19-2.66) for CRC and 1.48 (1.04-2.05) for advanced adenoma. Conclusions: The procedure of selection of FDRs was extremely ineffective. Due to previous negative screening tests, the prevalence of disease was less than expected. A population-based FOBT screening programme is a highly unsuitable setting for the provision of surveillance to FDRs of CRC patients.
AB - Background: In some Italian areas, colonoscopic surveillance of first-degree relatives (FDRs) of colorectal cancer (CRC) patients is provided as a part of local population-based faecal occult blood test (FOBT) screening programmes. The objective of the present study was to assess the feasibility and early results of this surveillance model. Methods: Data from district screening centres were used to evaluate the process of identification and selection of eligible FDRs (residence in the Emilia-Romagna Region, age 40-75 years, no recent colonoscopy) of screen-detected CRC patients and the detected prevalence of disease. The probability for an FDR to undergo colonoscopy and to be diagnosed with CRC and advanced adenoma was estimated using the Kaplan-Meier method. The sex- and age-standardised ratio of detected prevalence to that expected based on results from a colonoscopy screening study of the Italian general population was estimated. Results: Between 2005 and 2011, 9319 FDRs of 2437 screen-detected CRC patients (3.8 per patient) were identified and contacted. Their likelihood of being eligible for, and accepting, colonoscopy was 0.11 (95% confidence interval: 0.11-0.12). Among the 926 subjects undergoing colonoscopy, the prevalence of previous negative screening FOBT was 63%. Eleven CRCs (1.2%) and 100 advanced adenomas (10.8%) were detected. The standardised ratio of detected prevalence to that expected was 0.91 (95% confidence interval: 0.19-2.66) for CRC and 1.48 (1.04-2.05) for advanced adenoma. Conclusions: The procedure of selection of FDRs was extremely ineffective. Due to previous negative screening tests, the prevalence of disease was less than expected. A population-based FOBT screening programme is a highly unsuitable setting for the provision of surveillance to FDRs of CRC patients.
KW - Colonoscopy
KW - Colorectal neoplasm
KW - Faecal occult blood test
KW - Family history
KW - Mass screening
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U2 - 10.1016/j.canep.2013.04.004
DO - 10.1016/j.canep.2013.04.004
M3 - Article
C2 - 23683843
AN - SCOPUS:84878913374
VL - 37
SP - 469
EP - 473
JO - Cancer Epidemiology
JF - Cancer Epidemiology
SN - 1877-7821
IS - 4
ER -