UICC World Cancer Congress 2006

Objective: The aim of our study was to evaluate the utility of extending the application of screening methods for early detection of colorectal cancer also to those patients which were admitted for other symptomatology than colorectal. These data would be useful in setting a functional national screening program, as secondary prevention (early detection and removal of premalignant colorectal lesions) seems to be the most efficient method to fight against colorectal cancer. Methods: The study included patients admitted between 2001 and 2004 in “Sf. Spiridon” Universitary Hospital, Iasi, Romania. The first study subgroup (2001-2002) included 3,934 patients presenting colorectal symptomatology. They were investigated for tumor lesions using FOBT or endoscopy. The second subgroup (2003-2004) included patients with or without colorectal symptomatology, 4523 and 3853, respectively. They were investigated using the same screening methods. After complete removal, all adenomas and carcinomas were microscopically evaluated (according to WHO 2000 classification). We could compare the incidence and the clinico-histopathological characteristics of the colorectal lesions, between the two subgroups of patients. Results: In the first study subgroup we diagnosed adenomas in 1,405 patients (35.71%) and carcinomas in 635 patients (16.14%). In the second subgroup, adenomas were diagnosed in 1803 (39.86%) symptomatic and 1009 (26.18%) asymptomatic patients, while carcinomas were detected in 656 (14.5%) symptomatic and 72 (1.86%) asymptomatic patients (most of them being pT1-2). The study showed that due to extensive investigations, the number of diagnosed premalignant lesions (adenomas) increased over two times, while the rate of adenocarcinomas in advanced stages (pT3-4) decreased.