title: The first 2 years of colorectal cancer screening in Ferrara, Italy.
abstract: We report on the first screening round in the District of Ferrara, a region of Emilia-Romagna, carried out between March 2005 and March 2007 to illustrate the effort of colorectal cancer (CRC) screening from administration and information to therapy and follow-up. After invitation of 38 344 persons aged 50-69 years (28.5%), 19 480 (50.8%) accepted the immunological faecal occult blood test, with 1 149 (6%) resulting positive. One thousand and one individuals (88.2%) who tested positive for immunological faecal occult blood test accepted examination by either colonoscopy (99.5%) or barium enema (0.5%). Out of 996 screenees having a colonoscopy, 231 had low-risk adenomas (23.2%) and 239 had high-risk adenomas (24%), and were treated endoscopically (96%) or surgically (4%). Ninety-one cancers were diagnosed in 9.1% of colonoscopies (Dukes stadia: A, 58.2%; B, 19.8%; C, 18.7%; D, 3.3%). Fourteen cancers (all in polyps) were treated endoscopically, and the remaining 77 were treated by surgery. One Dukes B patient and 13 of 17 Dukes C patients received adjuvant chemotherapy. Three Dukes D patients had chemotherapy only. During the 2-year study period, 87 screenees had a follow-up colonoscopy: no neoplasia was found in 35 patients initially diagnosed with cancer; low-risk adenomas were found in 31 of 52 patients with initial high-risk adenomas. In conclusion, the first CRC screening round in Ferrara was easy to organize, had a high acceptance, and detected 91 cancers (78% of which were in Dukes stages A and B, compared with only 40% in sporadic CRC in the same background population). Chemotherapy was necessary in 17 cases. This report may motivate other health authorities to initiate CRC screening campaigns.
authors: Unit of Gastroenterology, Departments of General Surgery, S Anna University Hospital of Ferrara, Lagosanto, Ferrara, Italy.
authors: Vincenzo G
authors: VG
authors: Matarese
authors: Carlo Vittorio
authors: CV
authors: Feo
authors: Giovanni
authors: G
authors: Lanza
authors: Nadia
authors: N
authors: Fusetti
authors: Maria Cristina
authors: MC
authors: Carpanelli
authors: Serena
authors: S
authors: Cataldo
authors: Viviana
authors: V
authors: Cifalà
authors: Stefano
authors: S
authors: Ferretti
authors: Roberta
authors: R
authors: Gafà
authors: Marina
authors: M
authors: Marzola
authors: Enrica
authors: E
authors: Montanari
authors: Caterina
authors: C
authors: Palmonari
authors: Loredana
authors: L
authors: Simone
authors: Lucio
authors: L
authors: Trevisani
authors: Reinhold
authors: R
authors: Stockbrugger
authors: Sergio
authors: S
authors: Gullini
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000517:prevention & control; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011379:Prognosis; D012307:Risk Factors