title: Colorectal cancer screening: results of a 5-year program in asymptomatic subjects at increased risk.
abstract: OBJECTIVE
  The province of Ferrara has one of the highest incidences of colorectal cancer (CRC) in Italy. In January 2000, we set up a colonoscopy screening program focussing on first-degree relatives of CRC patients. We now report the results 5 years after the beginning of the project. SCREENEES AND METHODS: In October 1999, we started a campaign stressing the usefulness of colonoscopy for the first-degree relatives of CRC patients. Subjects included in the screening program were aged between 45 and 75 years with at least one first-degree relative affected by CRC. They were invited to an interview where a physician suggested colonoscopy as a screening option.
  
  
  RESULTS
  In 5 years, 776 subjects were interviewed and 733 (94.4%) agreed to an endoscopic examination (M/F:375/401; mean age 55 years): 562 colonoscopies were performed. Adenomas and cancers were found in 122 (21.7%) and 12 (2.1%) subjects, respectively. Histological examination in 181 persons with lesions (32.8%) showed (most serious lesion quoted) 47 hyperplastic polyps (26% of all lesions), 2 serrated adenomas (1.1%), 68 tubular adenomas (48%), 24 tubulovillous adenomas (13.3%), 9 adenomas with high grade dysplasia (5%) and 12 adenocarcinomas (6.6%). The majority of the cancers were at an early stage (8 Dukes A and 3 Dukes B). Sedation was used in only 42 colonoscopies (7.5%).
  
  
  CONCLUSIONS
  A colonoscopy-based screening in this selected high-risk population is feasible. Even without sedation subjects readily agreed to the endoscopic procedure. We identified a significant number of advanced neoplasms and cancers at an early stage suggesting that this could be a useful tool in early identification of CRC.
authors.affiliation: Department of Gastroenterology and GI Endoscopy, University Hospital, Ferrara, Italy. a.pezzoli@ospfe.it <a.pezzoli@ospfe.it>
authors.forename: A
authors.initials: A
authors.lastname: Pezzoli
authors.forename: V
authors.initials: V
authors.lastname: Matarese
authors.forename: M
authors.initials: M
authors.lastname: Rubini
authors.forename: M
authors.initials: M
authors.lastname: Simoni
authors.forename: G C
authors.initials: GC
authors.lastname: Caravelli
authors.forename: R
authors.initials: R
authors.lastname: Stockbrugger
authors.forename: V
authors.initials: V
authors.lastname: Cifalà
authors.forename: S
authors.initials: S
authors.lastname: Boccia
authors.forename: C
authors.initials: C
authors.lastname: Feo
authors.forename: L
authors.initials: L
authors.lastname: Simone
authors.forename: L
authors.initials: L
authors.lastname: Trevisani
authors.forename: A
authors.initials: A
authors.lastname: Liboni
authors.forename: S
authors.initials: S
authors.lastname: Gullini
mesh_terms: D000236:Adenoma / Q000175:diagnosis; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005820:Genetic Testing / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors