Screening for colorectal tumors - results of two years experience

The experience after two years of systematic colorectal tumors screening of 603 subjects, aged between 40 and 70, is reported. All subjects were submitted to proctoscopy (P) and air filled barium enema (AFBE). Total frequency of screened tumors: 15.25%. More than 85% of the tumors were found in the recto-sigmoid. Two subgroups were identified in this population. In subgroup A, 125 subjects were submitted to P, AFBE and flexible pansigmoidoscopy (FP). Percentage of screened tumors is 19.2%. Sensitivity rate of radiology for exploration of the recto-sigmoid area, as compared to FP is rather low: 0.41. In subgroup B, 165 subjects were submitted to hemoccult, P, AFBE and colonoscopy when an abnormal or dubious image was shown by AFBE. The comparative study of these different means of investigation shows a very low rate of sensitivity of hemoccult: 0.16. In addition, the percentage of screened colorectal tumors is significantly higher (p less than 0.01) in subjects with personal or family history of polyp or carcinoma: 22%, compared to the incidence in the remaining population of 13%. Flexible pansigmoidoscopy is recommended for systematic screening of colorectal tumors in subjects older than 40.