[Screening for colorectal cancer and polyps].

Area of Science:

• Gastroenterology
• Oncology
• Preventive Medicine

Background:

• Early detection of colorectal neoplasms through screening can improve prognosis or prevent cancer.
• Colorectal cancer screening methods include fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy.

Purpose of the Study:

• To compare the effectiveness of three screening methods for colorectal neoplasms.
• To assess the risk of colorectal neoplasm in different Jewish ethnic groups.

Main Methods:

• 1101 asymptomatic individuals were screened using fecal occult blood tests, flexible sigmoidoscopy, and colonoscopy.
• Sensitivity and positive predictive value were calculated for each screening method.

Main Results:

• Flexible sigmoidoscopy had a higher diagnostic yield (7.8%) than fecal occult blood tests (1.9%).
• Sigmoidoscopy detected 41 polyps and 1 cancer; colonoscopy detected 37 polyps and 1 cancer.
• Fecal occult blood test showed low sensitivity (2.1%) and positive predictive value (6.7%).
• Colorectal neoplasm risk was found to be equal in Jews of oriental and occidental origin.

Conclusions:

• Flexible sigmoidoscopy is the most effective screening method for colorectal neoplasms due to its high diagnostic yield.
• Screening programs are crucial for early detection and improved outcomes in colorectal cancer.
• This study highlights the importance of considering ethnicity in cancer risk assessments.