Author/Authors :
Massimiliano Sassoli de Bianchi، نويسنده , , Priscilla and Campari، نويسنده , , Cinzia and Mancini، نويسنده , , Silvia and Giuliani، نويسنده , , Orietta and Landi، نويسنده , , Patrizia and Paterlini، نويسنده , , Luisa and Naldoni، نويسنده , , Carlo and Finarelli، نويسنده , , Alba C. and Falcini، نويسنده , , Fabio and Ponz de Leon، نويسنده , , Maurizio and Sassatelli، نويسنده , , Romano and Borciani، نويسنده , , Elisabetta and Fornari، نويسنده , , Fabio and Gatti، نويسنده , , Giorgio and Zatelli، نويسنده , , Marella and Zurlini، نويسنده , , Corrado and Rossi، نويسنده , , Federica Ginanni-Corradini، نويسنده , , Rossella and Olivetti، نويسنده , , Rossella and Manfredi، نويسنده , , Marilena and Baldazzi، نويسنده , , Paola and Nannini، نويسنده , , Roberto and Zanarini، نويسنده , , Stefano and Matarese، نويسنده , , Vincenzo G. and Palmonari، نويسنده , , Caterina and Triossi، نويسنده , , Omero and Gordini، نويسنده , , Sonia and Vattiato، نويسنده , , Rosa and Colamartini، نويسنده , , Americo and Palazzi، نويسنده , , Mauro and Severi، نويسنده , , Mirna and Briganti، نويسنده , , Laura and Giovanardi، نويسنده , , Mauro and Casale، نويسنده , , Coralba and Bucchi، نويسنده , , Lauro، نويسنده ,
Abstract :
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.
