title: Opportunistic colorectal cancer screening using colonoscopy. Comparative results between two historical cohorts in Bucharest, Romania.
abstract: OBJECTIVE
  Even though Romania has one of the highest incidence and mortality in colorectal cancer (CRC) in Europe, there is currently no organized screening program. We aimed to assess the results of our opportunistic CRC screening using colonoscopy.
  
  
  METHODS
  A single center retrospective study to include all opportunistic screening colonoscopies performed in two 18 month periods (2007-2008 and 2012-2013) was designed. All asymptomatic individuals without a personal or family history of adenoma or CRC and with complete colonoscopy performed in these two time periods were included.
  
  
  RESULTS
  We included 1,807 individuals, 882 in the first period, 925 in the second period. There were 389 individuals aged below 50, 1,351 between 50 and 75 and 67 older than 75 years. There were 956 women (52.9%), with a mean age of 58.5 (median 59, range 23-97). The detection rates were 12.6% for adenomas (6.1% for advanced adenoma) and 3.4% for adenocarcinoma. Adenoma incidence (4.9% in subjects under 50, 14.7% in those aged 50 to 75, and 16.4% in those older than 75, p<0.0001) and size (6.3mm in subjects younger than 50, 9.2mm in those 50 to 75 and 10.8mm in those older than 75, p=0.015) significantly increased with age. Adenoma incidence increased in the second period (14.8% vs. 10.3%, p=0.005), while adenoma size decreased in the second period (8.4mm vs. 10mm, p=0.006). There were no procedure related complications.
  
  
  CONCLUSIONS
  The neoplasia detection rate was 16% (12.6% adenoma, 3.4% adenocarcinoma). Adenoma incidence and size increased with age in both cohorts. In the second screening period significantly more and smaller adenomas were detected.
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania. mirela.ionescu80@gmail.com.
authors.forename: Elena Mirela
authors.initials: EM
authors.lastname: Ionescu
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania.
authors.forename: Tudor
authors.initials: T
authors.lastname: Nicolaie
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania.
authors.forename: Serban Ion
authors.initials: SI
authors.lastname: Gologan
authors.affiliation: Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania.
authors.forename: Ana
authors.initials: A
authors.lastname: Mocanu
authors.affiliation: Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ditescu
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania.
authors.forename: Tudor
authors.initials: T
authors.lastname: Arbanas
authors.affiliation: Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania.
authors.forename: Adriana
authors.initials: A
authors.lastname: Stoicescu
authors.affiliation: Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania.
authors.forename: Adriana
authors.initials: A
authors.lastname: Teiusanu
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Gastroenterology Department, Elias Emergency Hospital, Bucharest, Romania.
authors.forename: Mihai
authors.initials: M
authors.lastname: Andrei
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Gastroenterology and Hepatology Clinic, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Mircea
authors.initials: M
authors.lastname: Diculescu
authors.affiliation: Carol Davila University of Medicine and Pharmacy, Gastroenterology and Hepatology Clinic, Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: Mihai
authors.initials: M
authors.lastname: Ciocirlan
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology*; D000236:Adenoma / Q000453:epidemiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology; D013997:Time Factors; D047368:Tumor Burden; D055815:Young Adult