Screening for colorectal neoplasia: a multicenter study in Israel.
We report the design and results of the first Israeli multicenter screening program for colorectal neoplasia. The screening protocol comprised a risk questionnaire, fecal occult blood testing, flexible sigmoidoscopy and colonoscopy. A total of 5,601 individuals were screened in five medical centers, 55% being asymptomatic with low or average risk. Colorectal tumors were found in 12.3% of screenees, the majority being adenomas. The risk for large bowel neoplasia was greatest in persons with a personal history of colorectal neoplasia (neoplasia rate 473.2/10(3)) and was increased in those with inflammatory bowel disease, a family history of colorectal tumor, or past history of cured breast cancer. European-born Jews had a 50% greater risk than non-European-born Jews. Persons at high risk were more likely to return for repeat screening than those at low or average risk. However, approximately 15% of persons at high risk actually thought that they were of average risk. Fecal occult blood testing was markedly less reliable than flexible sigmoidoscopy and had a false-negative rate of 84.4%. The results demonstrate that existing medical facilities in Israel can be used to screen at least those individuals with increased risk for colorectal neoplasia.
Odes
H S
HS
Gastroenterology Department, Soroka Medical Center, Beer Sheva, Israel.
Rozen
P
P
Ron
E
E
Bass
D
D
Bat
L
L
Keren
S
S
Fireman
Z
Z
Shemesh
E
E
Krugliak
P
P
Fraser
G
G
D000236:Adenoma / Q000453:epidemiology / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009780:Occult Blood; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012812:Sigmoidoscopy