Résumé
Des arguments actuels en études observationnelles, de cohortes ou cas-témoins montrent que la coloscopie réduit de 70 % non seulement la mortalité, mais aussi l’incidence du cancer colorectal (CCR). Les études en population suggèrent que l’efficacité ultime des stratégies de dépistage « en deux temps » après Hémoccult® ou rectosigmoïdoscopie positive est directement liée au taux de recours à la coloscopie parmi la population cible et qu’un taux de coloscopie d’environ 20 % est nécessaire pour obtenir une réduction durable de la mortalité et de l’incidence du CCR dans la population considérée. Alors qu’il n’existe pas d’argument publié sur l’efficacité du test immunologique et que les pays ayant proposé une attitude multimodale au dépistage enregistrent des résultats encourageants, il est important de savoir si les discours des gastroentérologues sont en accord avec leurs actes. Ainsi, 65 % souhaitent ou ont fait une coloscopie de dépistage et 72 % sont en faveur d’une stratégie et d’une offre multimodale.
Abstract
Current arguments in observational, cohort and case-controlled studies show that colonoscopy reduces not only mortality rates but also the incidence of colorectal cancer (CRC) by 70%. Population studies suggest that the ultimate efficacy of dual screening strategies following positive hemoccult or proctosigmoidoscopy results is directly linked to the rate of colonoscopy use among the target population, and that a colonoscopy rate of approximately 20% is necessary to achieve a sustainable reduction in mortality and incidence of CRC in the population considered. Although there is no published argument regarding the efficacy of immunological testing, and that the countries that have proposed a multiple method screening programme are registering encouraging results, it is important to ascertain whether the opinions of gastroenterologists are in agreement with the procedures they perform.
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Heresbach, D., Letard, J.C., Ingrand, I. et al. Qui souhaite quoi et comment pour prévenir le cancer colorectal ? Une enquête prospective parmi les gastroentérologues en 2014. Acta Endosc 45, 280–284 (2015). https://doi.org/10.1007/s10190-015-0507-4
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DOI: https://doi.org/10.1007/s10190-015-0507-4