Fourteen-year retrospective study on fecal occult blood test in a private laboratory in Brazil / Pesquisa de sangue oculto nas fezes em um laboratório privado: Um estudo retrospectivo de 14 anos
DOI:
https://doi.org/10.34119/bjhrv4n6-141Keywords:
Neoplasias Colorretais, Programas de Rastreamento, Sangue Oculto, Guaiáco.Abstract
Introdução: O câncer colorretal (CCR) é a terceira neoplasia mais comum no mundo e apresenta altas taxas de mortalidade. A pesquisa de sangue oculto nas fezes (PSOF) é um método de rastreamento simples, não invasivo e validado para rastreamento do CCR. Objetivo: Avaliar os diferentes métodos de PSOF, suas taxas de positividade ao longo dos anos e aderência individual ao exame. Metodologia: Trata-se de estudo transversal retrospectivo que avaliou todos os registros de PSOF realizadas em um laboratório de 2005 a 2019. Os pacientes foram agrupados por faixa etária e sexo e a taxa de positividade foi analisada. A PSOF foi feita em duas etapas até 2015: triagem com guáiaco e, se positivo, confirmava-se o resultado com imunoquímico. Desde 2016, todas as PSOF foram realizadas com o imunoquímico. A amostra final foi de 316,287 exames de 136,735 pacientes. Resultados: 68% dos exames foram realizados em mulheres. Homens tiveram mais resultados positivos (p < 0.001). Houve diferença significativa nas taxas de positividade até 2015 e de 2016 a 2019, quando o único método realizado foi o imunoquímico (1.3% vs. 10.0%; p < 0.001). A proporção de resultados positivos aumentou significativamente com a realização de mais de uma amostra e de mais exames ao longo dos anos (p < 0.001). Conclusão: Esse estudo mostra a importância de campanhas de rastreamento de CCR direcionadas aos homens. O método imunoquímico deve ser empregado como padrão devido a sua maior sensibilidade. Indivíduos que realizaram mais amostras e mais exames têm chance aumentada de rastreamento positivo.
References
Doubeni C. Tests for screening for colorectal cancer. In: UpToDate. Post TW (Ed), UpToDate, Waltham, MA. 2021. Accessed on January 24, 2021.
World Health Organization International Agency for Research on Cancer (IARC). GLOBOCAN: Colorectal cancer [Internet]. 2020. Available from: https://gco.iarc.fr/today/data/factsheets/cancers/10_8_9-Colorectum-fact-sheet.pdf. Accessed on January 24, 2021.Hewitson P, Glasziou P, Watson E, Towler B, Irwig L.
Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (Hemoccult): An update. Am J Gastroenterol. 2008 Jun; 103:1541-1549.
Park D Il, Ryu S, Kim YH, et al. Comparison of guaiac-based and quantitative immunochemical fecal occult blood testing in a population at average risk undergoing colorectal cancer screening. Am J Gastroenterol. 2010 Sep;105: 2017-2025.
American Cancer Society. American Cancer Society Guideline for Colorectal Cancer Screening. Am Cancer Soc Guidel Color Cancer Screen. 2018.
Steele RJC, Kostourou I, McClements P, et al. Effect of gender, age and deprivation on key performance indicators in a FOBT-based colorectal screening programme. J Med Screen. 2010;17:68-74.
Blom J, Kilpeläinen S, Hultcrantz R, Törnberg S. Five-year experience of organized colorectal cancer screening in a Swedish population - increased compliance with age, female gender, and subsequent screening round. J Med Screen. 2014 Sep;21: 144-150.
Quyn AJ, Fraser CG, Stanners G, et al. Uptake trends in the Scottish Bowel Screening Programme and the influences of age, sex, and deprivation. J Med Screen. 2018 Mar;25: 24-31.
Navarro M, Nicolas A, Ferrandez A, Lanas A. Colorectal cancer population screening programs worldwide in 2016: An update.World Journal of Gastroenterology. 2017 May 28; 23: 3632-3642.
Schreuders EH, Ruco A, Rabeneck L, et al. Colorectal cancer screening: A global overview of existing programmes. Gut. 2015 Oct;64: 1637-1649.
Winawer SJ. The History of Colorectal Cancer Screening: A Personal Perspective. Dig. Dis. Sci. 2015 Mar; 60: 596-608.
Peacock O, Watts ES, Hanna N, Kerr K, Goddard AF, Lund JN. Inappropriate use of the faecal occult blood test outside of the National Health Service colorectal cancer screening programme. Eur J Gastroenterol Hepatol. 2012 Nov;24: 1270-1275.
Powell AA, Saini SD, Breitenstein MK, et al. Rates and Correlates of Potentially Inappropriate Colorectal Cancer Screening in the Veterans Health Administration. J Gen Intern Med. 2015 Jun;30: 732-741.
Van Rijn AF, Stroobants AK, Deutekom M, et al. Inappropriate use of the faecal occult blood test in a university hospital in the Netherlands. Eur J Gastroenterol Hepatol. 2012 Nov;24: 1266-1269.
Blom J, Löwbeer C, Elfström KM, et al. Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate. J Med Screen. 2019 Jun;26: 92-97.
Chait MM. Review: Lower gastrointestinal bleeding in the elderly. World J Gastrointest Endosc. 2010 May 16; 2: 147-154.
Millan M, Merino S, Caro A, Feliu F, Escuder J, Francesch T. Treatment of colorectal cancer in the elderly. World J Gastrointest Oncol. 2015 Oct 15;7: 204-220.
Lee JK, Liles EG, Bent S, Levin TR, Corley DA. Accuracy of fecal immunochemical tests for colorectal cancer: Systematic review and meta-analysis. Ann Intern Med. 2014 Feb 4; 160: 171.
Hassan C, Rossi PG, Camilloni L, et al. Meta-analysis: Adherence to colorectal cancer screening and the detection rate for advanced neoplasia, according to the type of screening test. Aliment Pharmacol Ther. 2012 Oct;36: 929-940.
Levi Z, Birkenfeld S, Vilkin A, et al. A higher detection rate for colorectal cancer and advanced adenomatous polyp for screening with immunochemical fecal occult blood test than guaiac fecal occult blood test, despite lower compliance rate. A prospective, controlled, feasibility study. Int J Cancer. 2011 May 15;128: 2415-2424.
Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM. American college of gastroenterology guidelines for colorectal cancer screening 2008. Am J Gastroenterol. 2009 Mar;104: 739-750.
Tinmouth J, Lansdorp-Vogelaar I, Allison JE. Faecal immunochemical tests versus guaiac faecal occult blood tests: What clinicians and colorectal cancer screening programme organisers need to know. Gut. 2015 Aug;64: 1327-1337.
Wilschut JA, Habbema JDF, Van Leerdam ME, et al. Fecal occult blood testing when colonoscopy capacity is limited. J Natl Cancer Inst. 2011 Dec 7;103: 1741-1751.
Kapidzic A, Van Roon AHC, Van Leerdam ME, et al. Attendance and diagnostic yield of repeated two-sample faecal immunochemical test screening for colorectal cancer. Gut. 2017 Jan;66: 118-123.
Schreuders EH, Grobbee EJ, Nieuwenburg SAV, et al. Multiple rounds of one sample versus two sample faecal immunochemical test-based colorectal cancer screening: a population-based study. Lancet Gastroenterol Hepatol. 2019 Aug;4: 622-631.
Mattar R, Marques SB, Minata MK, da Silva-Etto JMK, Sakai P, De Moura EGH. Diagnostic accuracy of one sample or two samples quantitative fecal immunochemical tests for intestinal neoplasia detection. Arq Gastroenterol. 2020 Sep;57: 316-322.
Wu D, Luo HQ, Zhou WX, Qian JM, Li JN. The performance of three-sample qualitative immunochemical fecal test to detect colorectal adenoma and cancer in gastrointestinal outpatients: An observational study. PLoS One. 2014 Sep 8;9: e106648.
Auge JM, Fraser CG, Rodriguez C, et al. Clinical utility of one versus two faecal immunochemical test samples in the detection of advanced colorectal neoplasia in symptomatic patients. Clin Chem Lab Med. 2016 Jan;54: 125-132.
Robertson DJ, Lee JK, Boland CR, et al. Recommendations on Fecal Immunochemical Testing to Screen for Colorectal Neoplasia: A Consensus Statement by the US Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2017 Apr;152: 1217-1237.
Muinuddin A, Aslahi R, Hopman WM, Paterson WG. Relationship between the number of positive fecal occult blood tests and the diagnostic yield of colonoscopy. Can J Gastroenterol. 2013 Feb;27: 90-94.
Wieten E, de Klerk CM, Lansdorp-Vogelaar I, Bossuyt PM, Dekker E, Spaander MCW. A Quarter of Participants With Advanced Neoplasia Have Discordant Results From 2-Sample Fecal Immunochemical Tests for Colorectal Cancer Screening. Clin Gastroenterol Hepatol. 2020 Jul;18: 1805-1811.
