The efficacy of the fecal occult blood test in colorectal cancer screening and evaluation with the literature: Two-year follow-up results of Rize province

INTRODUCTION: Early detection of colorectal cancer (CRC) reduces mortality and morbidity, and reduces treatment costs. It is possible to detect precancerous lesion or early stage tumor with screening programs. In this study, the efficacy of the screening program was evaluated by examining colonoscopy findings and clinicopathological data of the patients who were taken to CRC screening program by Rize province Cancer Early Diagnosis Screening and Training Center and who were referred to our clinic with positive fecal occult blood test (FOBT) result.
METHODS: A total of 144 patients with positive FOBT (Wondfo One Step Fecal Occult Blood Test, Biotech Co.Ltd., Guangzhou, China) results were included in the study. Data were retrospectively reviewed from patient files. Demographic data of age and gender, endoscopic findings, anal physical examination findings, histopathological results, FOBT positivity rate, polyp + cancer detection rate and cancer detection rates were evaluated.
RESULTS: In this study, 74 of the patients (51.4%) were male and 70 (48.6%) were female and the mean age was 60.1 (min 50-max 70). In 109 patients (75.7%) colonoscopic findings were normal. Hemorrhoid / anal fissure was the cause of FOBT positivity in 31 patients (21.5 %). Colonoscopy positive patients were as follows; polyp in 21 patients (14.6 %), colonic diverticulum in 7 patients (4.9 %), nonspecific inflammation in 5 patients (3.5 %) and macroscopic tumor in 2 patients (1.4 %). FOBT positivity rate was 1.2 % (n: 144), polyp + cancer detection rate was 0.19% (n: 23) and cancer detection rate was 0.017% (n: 2).
DISCUSSION AND CONCLUSION: Immunochemical tests are the preferred choice for CRC in modern screening program. In our study; the rates of participants, test positivity and malignancy were found to be quite low. Promoting and encouraging public awareness of the need for FOBT and the correct implementation of FOBTs will contribute to the success of screening programs.

Kolorektal kanser taramada uygulanan gaytada gizli kan testinin etkinliði ve literatür eþliðinde deðerlendirilmesi: Rize ili iki yýllýk deðerlendirme

GÝRÝÞ ve AMAÇ: Kolorektal kanser (KRK)’ in erken evrede tespiti mortalite ve morbidite azalmasýnýn yaný sýra tedavi maliyetlerini de düþürmektedir. Tarama programlarý ile prekanseröz lezyonu veya erken evre tümörü saptamak münkündür. Bu çalýþmada Rize ili Kanser Erken Teþhis Tarama ve Eðitim Merkezince KRK tarama programýna alýnan ve gaitada gizli kan testi (GGKT) pozitif saptanarak merkezimize yönlendirilen hastalarýn kolonoskopi bulgularý ve klinikopatolojik verileri incelenerek tarama programýnýn etkinliði deðerlendirilmiþtir.
YÖNTEM ve GEREÇLER: GGKT sonucu pozitif saptanan 144 hasta çalýþmaya dahil edildi. Veriler hasta dosyalarýndan retrospektif olarak tarandý. Çalýþma kapsamýnda hastalarýn yaþ, cinsiyet gibi demografik verileri ile endoskopide saptanan bulgular, anal fizik muayene bulgusu, histopatolojik sonuçlar, GGKT pozitiflik oraný, polip + kanser saptanma oraný ve kanser saptanma oranlarý tespit edildi.
BULGULAR: Çalýþmada hastalarýn 74’ ü (% 51.4) erkek, 70’ i (% 48.6) kadýn ve yaþ ortalamasý 60.1 (min 50-max 70) idi. Toplamda 109 hastada (% 75.7) kolonoskopik bulgular normal idi. 31 hastada (% 21.5) GGKT pozitifliðinin sebebi hemoroid/anal fissür idi. Kolonoskopisi pozitif olanlardan 21 hastada (% 14.6) polip, 7 hastada (% 4.9) kolon divertikülü, 5 hastada (% 3.5) nonspesifik inflamasyon ve 2 hastada (% 1.4) makroskopik tümör saptandý. GGKT pozitiflik oraný % 1.2 (n: 144), polip + kanser saptanma oraný % 0.19 (n: 23) ve kanser saptanma oraný % 0.017 (n: 2) idi.
TARTIÞMA ve SONUÇ: Ýmmünokimyasal testler modern toplum tarama programýnda KRK için tercih edilen seçenektir. Çalýþmamýzda katýlýmcý sayýsý, test pozitifliði ve malignite tespit oranlarý oldukça düþük saptanmýþtýr. Toplumun GGKT gerekliliði konusunda bilinçlendirilerek teþvik edilmesi ve GGKT’ lerin doðru uygulanmasý tarama programlarýnýn baþarýya ulaþmasýna katký saðlayacaktýr.