Recognition of adenoma to carcinoma progression has established colorectal cancer as a preventable malignancy.
Colorectal cancer is, therefore, an ideal malignancy for preventative screening given the presence of a benign precursor.
Dr Daniel Brosseuk and colleagues from Canada established a pilot low-risk endoscopic screening clinic.
The team performed a retrospective chart review of all patients referred to a new low-risk colorectal cancer endoscopic screening clinic from 2004 to 2005.
The research team further analyzed patients with adenomas or carcinomas, regarding location of neoplasm and pathologic findings.
A total of 379 low-risk patients attended the colorectal cancer screening clinics.
|18% had neoplasms, and 1% had curable cancers resected|
|American Journal of Surgery|
The age range of the patients was 50 to 86 years.
The researchers reported that the male to female ratio was 254 to 128.
A total of 257 patients had flexible sigmoidoscopy as the initial screen, and 24 patients had partial colonoscopy.
The team noted that a further 98 patients had complete initial colonoscopy.
A total of 152 patients had polyps removed, of which 63 patients had adenomas, 3 had adenocarcinomas, and 1 had a carcinoid.
The researchers found that the remaining patients had an assortment of nonneoplastic polyps.
Of the 67 patients with neoplasms, 50 were left of the splenic flexure, and 11 were right of the splenic flexure.
The team observed that 5 patients had lesions both proximal and distal to the flexure.
The researchers noted that 32 of the 67 patients had complete colonoscopy at the initial procedure.
So far, only 21 patients have had completion colonoscopies, of which 9 patients had further neoplasms identified beyond the splenic flexure.
All 3 patients with carcinoma had early tumors resected with curative intent, with negative margins and negative nodes.
Dr Brosseuk's team concluded, “Our initial experience with a low-risk general population colorectal cancer endoscopic screening clinic yielded 18% of patients with neoplasms, and 1% had curable cancers resected.”