Uptake, yield of neoplasia, and adverse effects of flexible sigmoidoscopy screening.
Background-A multicentre randomised controlled trial to evaluate screening by « once only » flexible sigmoidoscopy (FS) for prevention of bowel cancer is in progress.
Aims-To pilot the trial protocol examining rates of attendance, yield of neoplasia, and adverse effects.
Subjects-A total of 3540 subjects aged 55-64 years in Welwyn Garden City (WGC) and 19 706 in Leicester (LE).
Methods-Subjects responding positively to an « interest in screening » questionnaire were randomised to invitation for screening or control arms.
Small polyps were removed during screening.
Colonoscopy was undertaken for high risk polyps (more than two adenomas, size at least 1 cm, villous histology, severe dysplasia, or malignancy).
The remainder were discharged
In WGC and LE respectively, 59% and 61% indicated an interest in screening, of which 74% and 75% attended.
Adenomas were detected in 10% and 9%, respectively, and cancers in 7 per 1000 (in both centres), 55% at Dukes's stage A. The colonoscopy referral rate was 6% in both centres.
Mild, short lived bleeding occurred in 3%. One person died following surgery.
Conclusions-Compliance rates, yield of adenomas, and referral rate for colonoscopy were as expected, but cancer detection rates were higher.
Adverse effects following sigmoidoscopy or colonoscopy were mild and transient, but there was one postoperative death.
A randomised trial is necessary to evaluate fully the risks and benefits of this intervention.
Mots-clés Pascal : Carcinome, Côlon, Rectum, Dépistage, Surveillance, Evolution, Adénome, Polype, Exploration clinique, Colonoscopie, Intérêt, Complication, Etude cohorte, Homme, Tumeur maligne, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Rectum pathologie, Tumeur bénigne, Endoscopie
Mots-clés Pascal anglais : Carcinoma, Colon, Rectum, Medical screening, Surveillance, Evolution, Adenoma, Polyp, Clinical investigation, Colonoscopy, Interest, Complication, Cohort study, Human, Malignant tumor, Digestive diseases, Intestinal disease, Colonic disease, Rectal disease, Benign neoplasm, Endoscopy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0218990
Code Inist : 002B30A01C. Création : 11/09/1998.