TORNA ALL’ELENCO

Screening for colorectal cancer: A randomized trial comparing patient response of sigmoidoscopy vs. Ct colonography in United European Gastroenterology Journal

2014
AOU Città della Salute di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (6)Vedi tutti...

Senore C

Segnan N

Correale L


et alii...

Abstract

INTRODUCTION: CT colonograpphy has been proposed as non invasive, potentially acceptable, primary screening test for colorectal cancer (CRC). Only one randomised trial (1) has been conducted in a population base program, comparing CT colonography and colonoscopy. AIMS & METHODS: The aim of the study is to compare the participation rate of people invited to perform a Flexible Sigmoidoscopy (FS) to the response rate to the invitation to performa a CT Colonography (CTC), in the context of a population-based screening program. A sample of 58 years olds in the general population living in Turin, Italy were randomly allocated (1:1) to be invited by mail for primary screening with FS or CTC. Those with a history of CRC, adenomas, inFammatory bowel disease, recent colonoscopy, or two Erst-degree relatives with CRC were ineligible. Non-responders to invitation for FS screening were re-invited to attend for screening with CTC or immunological Fecal Occult Blood Test (FOBT). The primary outcome was screening participation rate, defined as numbers of invitees undergoing to the screening relative to the total number of invitees. Participation rates were also compared in a multivariate model to assess the effect of covariates (gender and screening arm). We conducted also a survey of a sample of particpants and of refusers to compare screenee experience with the two tests and to study reasons for non-participation. RESULTS: Of the 1984 eligible subjects included in the study, 995 and 989 were randomly assigned to CTC and FS arm, respectively. After excluding 27 people who could not be traced (1.4% across intervention groups), the participation rate following the first invitation and mail remainder was 27.1% (265/977) for FS and 30.5% (299/980) for CTC (P=0.09). Participation in screening with CTC was significantly better than with FS (34%, 95% CI: 30-39% vs. 26%, 95% CI: 22-31; OR, 1.6; 95% CI: 1.1-2.3; P=0.01) among men, while no difference between CTC and FS screening was

DOI : 10.1177/2050640614548974

Keywords

Italy; occult blood; intestine; adenoma; occult blood test; gender; model; screening test; arm; colonoscopy; male; female; population; gastroenterology; European; computed tomographic colonography; sigmoidoscopy; human; patient; colorectal cancer; screening;