title: International collaboration between Japan and Chile to improve detection rates in colorectal cancer screening.
abstract: BACKGROUND
  In Chile, mortality from colorectal cancer (CRC) has increased rapidly. To help address this issue, the Prevention Project for Neoplasia of the Colon and Rectum (PRENEC) program was initiated in 2012 with intensive support from Tokyo Medical and Dental University (TMDU) in Tokyo, Japan, as part of an international collaboration.
  
  
  METHODS
  From June 2012 to July 2014, a total of 10,575 asymptomatic participants were enrolled in PRENEC. Participants with positive immunochemical fecal occult blood test (iFOBT) results or a family history of CRC underwent colonoscopy. The colonoscopy results from a similar, previous project in Chile (PREVICOLON) were compared with those from PRENEC. Furthermore, the initial colonoscopies of 1562 participants in PRENEC were analyzed according to whether the colonoscopists were from TMDU or Chile.
  
  
  RESULTS
  The complete colonoscopy, adenoma detection, and cancer detection rates were 88.0%, 26.7%, and 1.1%, respectively, in PREVICOLON, while the corresponding values were 94.4%, 41.8%, and 6.0%, respectively, in PRENEC. In PRENEC, 107 cases of CRC were detected, amounting for 1.0% of all participants. Considering initial colonoscopies in PRENEC, the complete colonoscopy, adenoma detection, and cancer detection rates were 97.4%, 45.3%, and 9.3%, respectively, for physicians at TMDU and 93.3%, 41.5%, and 5.1%, respectively for Chilean physicians. The detection rates of intramucosal cancer were 7.3% and 3.7%, respectively, for TMDU and Chilean physicians.
  
  
  CONCLUSIONS
  Quality indicators of colonoscopy substantially improved from PREVICOLON to PRENEC. The assessments made by Chilean physicians alone were improved in PRENEC, but remained better in the TMDU group. Moreover, physicians from TMDU detected more CRCs than Chilean physicians, especially at earlier stages.
authors.affiliation: Latin American Collaborative Research Center of Tokyo Medical and Dental University, Santiago, Chile.|Department of Digestive and General Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Okada
authors.affiliation: Latin American Collaborative Research Center of Tokyo Medical and Dental University, Santiago, Chile.
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Latin American Collaborative Research Center of Tokyo Medical and Dental University, Santiago, Chile.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawachi
authors.affiliation: Latin American Collaborative Research Center of Tokyo Medical and Dental University, Santiago, Chile.|Department of Human Pathology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ito
authors.affiliation: Latin American Collaborative Research Center of Tokyo Medical and Dental University, Santiago, Chile.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Nishikage
authors.affiliation: Latin American Collaborative Research Center of Tokyo Medical and Dental University, Santiago, Chile.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Odagaki
authors.affiliation: Unit of Coloproctology, Las Condes Clinic, Santiago, Chile.
authors.forename: Alejandro J
authors.initials: AJ
authors.lastname: Zárate
authors.affiliation: Unit of Coloproctology, Las Condes Clinic, Santiago, Chile.
authors.forename: Udo
authors.initials: U
authors.lastname: Kronberg
authors.affiliation: Unit of Coloproctology, Las Condes Clinic, Santiago, Chile.
authors.forename: Francisco
authors.initials: F
authors.lastname: López-Köstner
authors.affiliation: Department of Digestive Endoscopy, Magallanes Hospital, Punta Arenas, Chile.
authors.forename: Stanko
authors.initials: S
authors.lastname: Karelovic
authors.affiliation: Department of Gastroenterology, Dr. Eduardo Pereira Hospital, Valparaiso, Chile.
authors.forename: Sergio
authors.initials: S
authors.lastname: Flores
authors.affiliation: Chilean-Japanese Institute for Digestive Diseases, San Borja Arriaran Hospital, Santiago, Chile.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Estela
authors.affiliation: Latin American Collaborative Research Center of Tokyo Medical and Dental University, Santiago, Chile.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsubaki
authors.affiliation: Department of Digestive and General Surgery, Tokyo Medical and Dental University, Tokyo, Japan.|Department of Surgical Specialties, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uetake
authors.affiliation: Department of Human Pathology, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Eishi
authors.affiliation: Department of Digestive and General Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Kawano
mesh_terms: D002677:Chile; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003299:Cooperative Behavior; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D007564:Japan; D008297:Male; D008403:Mass Screening; D008875:Middle Aged
keywords: adenoma detection rate; colonoscopy; colorectal cancer; diagnostic techniques and procedures; international cooperation; screening; training programs