The impact of colonoscopy for colorectal cancer screening
- 211 Downloads
Colorectal cancer is the second leading cause of cancer-related death. Prevention of this neoplasm should be achievable by screening programs in asymptomatic patients. The objective of the present paper is to assess colonoscopic findings in asymptomatic people submitted to screening.
A prospective study was undertaken on 153 consecutive asymptomatic people submitted to colonoscopy. Sex, age, previous diseases, and familial cases of cancer, as well as tobacco and alcohol ingestion were assessed. Patients with rectal macro- or microscopic bleeding and colorectal diseases were excluded. Bowel cleansing, polyps, angioectasias, diverticular disease, inflammation, and neoplasm were also verified. Polyps were classified according to their size, number, and location.
Colonoscopic alterations were detected in 99 individuals: polyps in 64.3 %, diverticular disease in 27.9 %, inflammatory mucosal alterations in 9.7 %, melanosis coli in 2.6 %, and angioectasias in 7.8 %. There was an increasing incidence of polyps in individuals older than 50 years. Multivariate logistic regression showed age and sex as predictive factors for polyps [odds ratio (OR) = 1.43; 1.19 < OR < 2.67].
The results of this investigation revealed a significant incidence of colonoscopic alterations in asymptomatic people submitted to colonoscopy for colorectal cancer screening.
KeywordsColonoscopy Screening Colorectal cancer Polyps Diverticular disease Angiodysplasia
Authors Luiz Ronaldo Alberti, David Correa Alves de Lima, Kelly Cristine de Lacerda Rodrigues, Marcos Paulo Lima Taranto, Sergio Henrique Leão Gonçalves, and Andy Petroianu have no conflicts of interest or financial ties to disclose.
- 3.Winawer S, Fletcher R, Rex D, Bond J, Burt R, Ferrucci J, Ganiats T, Levin T, Woolf S, Johnson D, Kirk L, Litin S, Simmang C (2003) Gastrointestinal consortium. Colorectal cancer screening and surveillance: clinical guidelines and rationale-update based on new evidence. Gastroenterology 124:544–560PubMedCrossRefGoogle Scholar
- 7.Schoen RE, Corle D, Cranston L, Weissfeld JL, Lance P, Burt R, Iber F, Shike M, Kikendall JW, Hasson M, Lewin KJ, Appelman HD, Paskett E, Selby JV, Lanza E, Schatzkin A (1998) Is colonoscopy needed for the nonadvanced adenoma found on sigmoidoscopy? The polyp prevention trial. Gastroenterology 115:533–541PubMedCrossRefGoogle Scholar
- 9.Petroianu A (2000) Pesquisa em Medicina. In: Petroianu A. Ética, Moral e Deontologia Médicas. Guanabara Koogan, Rio de Janeiro, pp 174–178Google Scholar
- 15.Pezzoli A, Matarese V, Rubini M, Simoni M, Caravelli GC, Stockbrugger R, CifalÃ V, Boccia S, Feo C, Simone L, Trevisani L, Liboni A, Gullini S (2007) Colorectal cancer screening: results of a 5-year program in asymptomatic subjects at increased risk. Dig Liver Dis 39:33–39PubMedCrossRefGoogle Scholar
- 22.Capobiango A, Araujo ID, Petroianu A (1992) Estudo epidemiológico das neoplasias malignas do intestino grosso e ãnus no estado de Minas Gerais. Rev Bras Colo Proct 12:5–8Google Scholar
- 24.Pox CP, Altenhofen L, Brenner H, Theilmeier A, von Stillfried D, Schmiegel W (2012) Efficacy of a nationwide screening colonoscopy program for colorectal cancer. Gastroenterology. doi: 10.1038/bjc.2012.104
- 25.Syse A, Aas GB, Loge JH (2012) Children and young adults with parents with cancer: a population-based study. Clin Epidemiol 4:41–52Google Scholar
- 26.Senore C, Ederle A, Benazzato L, Arrigoni A, Silvani M, Fantin A, Fracchia M, Armaroli P, Segnan N (2012) Offering people a choice for colorectal cancer screening. Gut. doi: 10.1136/gutjnl-2011-301862
- 27.van Rossum LG (2012) Colorectal cancer screening: how to stop a moving target. Clin Gastroenterol Hepatol 2:787–795Google Scholar
- 28.Gupta A, Samadder J, Elliott E, Sethi S, Schoenfeld P (2012) Prevalence of adenomas and advanced adenomas in patients in the 40- to 49-year age group undergoing screening colonoscopy because of a family history of adenoma/polyp in a first-degree relative. Gastrointest Endosc 75(4):705–711PubMedCrossRefGoogle Scholar
- 29.Qaseem A, Denberg TD, Hopkins RH Jr, Humphrey LL, Levine J, Sweet DE, Shekelle P, Clinical Guidelines Committee of the American College of Physicians (2012) Screening for colorectal cancer: a guidance statement from the American college of physicians. Ann Intern Med 156(5):378–386PubMedGoogle Scholar