The Feasibility of FOBT Tests in Colorectal Cancer Screening in Dobrogea
Background and aim. The high incidence of colorectal cancer in Eastern Europe and the declining mortality due to this pathology in the Western World, where screening programs for cancer are available, prove the necessity of implementing colorectal cancer screening in Romania, too. The aim of our study was to detect colorectal cancer in asymptomatic stages, where surgical treatment could be curative.
Method. The study was conducted in the Gastroenterology Department of Emergency Hospital, Constanta County, over a period of 18 months. We recruited apparently healthy people following all criteria recommended by the guidelines.
Results. From the total of 1098 patients included in the study, 162 patients with FOBT test positive followed the screening program undergoing colonoscopy or barium enema investigation. The rate of acceptance regarding the screening procedures was 70.3%. Advanced colon lesions were found in 14 patients (1.27%) and cancers in 7 cases (0.63%). According to TNM classification 5 cancers (71.4%) were surgically curative (TNM I/II/III) and 2 (28.5%) were advanced (TNM IV). The positive predictive value (PPVs) of FOBT for cancer was 4.7%.
Conclusion. Even if the effect of screening on mortality was not demonstrated, our study results confirm the necessity of colorectal cancer screening in our country, as it is worldwide, detecting cancers in curative stages. The detection rate of FOBT positive tests for neoplasia was similar to other studies.