There is evidence that early detection of colorectal cancer can lead to reduced mortality.
However, no organized colorectal cancer screening programs exist in Canada.
Dr Theodore Shapero and colleagues from Canada report on the safety, feasibility, and detection rates for the first Canadian community-based nurse-performed flexible sigmoidoscopy screening program for colorectal cancer.
The program was established in 1999.
The investigative team collected data from a prospective study of flexible sigmoidoscopy performed in 1818 individuals by nurses from 1999 to 2002.
Colonoscopy for persons with abnormalities was performed by an experienced gastroenterologist.
|The cancer detection rate was 3 per 1000 persons screened|
The patients had no previous history of colorectal cancer.
The investigators estimated differences between men and women in flexible sigmoidoscopy findings, and calculated relative risks.
Logistic regression was used to calculate odds ratios for advanced neoplasia.
Odds ratios were also obtained for mean depth of insertion of endoscope, and duration of flexible sigmoidoscopy procedure.
The team evaluated number, location and type of polyps found during flexible sigmoidoscopy and colonoscopy.
The investigators found abnormal results of the flexible sigmoidoscopy in 13% of flexible sigmoidoscopy participants, and 13% who underwent colonoscopy.
Distal neoplasms were detected in 9%.
The investigative team also adjusted for age and family history of colorectal cancer.
The risk of advanced neoplasm in the distal colon for men was about twice that for women.
The team detected cancer and high-grade dysplasia in less than 1% of participants screened, a detection rate of 3 per 1000 screened.
The investigators endoscopically treated 1 of the cancers, and all the lesions with high-grade dysplasia.
Dr Shapero's team concluded, “Our community-based nurse-performed flexible sigmoidoscopy screening program was feasible and safe.”
“The referral rate for colonoscopy was 13%, and the cancer detection rate was 3 per 1000 persons screened.”