BANFF, ALTA. — A screening program in Ontario was successful in detecting high-risk adenomas and colorectal cancer in patients referred because of positive fecal occult blood test results or a family history of colorectal cancer.
Dr. William G. Paterson and his colleagues reviewed the charts of 764 patients referred to the program; 122 were referred because of positive fecal occult blood tests (FOBTs). Of those, 14 patients were found to have cancer (11.4% diagnostic yield) and 30 had high-risk adenomas (24.6% diagnostic yield).
The remaining 642 patients screened through the program had a family history of colorectal cancer. Eleven cases of cancer (1.7% diagnostic yield) and 37 high-risk adenomas (5.8% diagnostic yield) were found. The yield for this cohort was not statistically different between patients whose first-degree relative was diagnosed at age 60 years or younger, or at older than 60 years of age.
A separate group of 2,011 patients underwent screening colonoscopy outside the newly developed program; 135 of them were considered to be of average risk, Dr. Paterson reported at the Canadian Digestive Diseases Week.
Among average-risk patients, one was found to have cancer (0.7% diagnostic yield); five others had high-risk adenoma (3.7% diagnostic yield).
“So the yield for those who came with a positive FOBT was significantly higher than all the other routes,” said Dr. Paterson, chief of gastroenterology at Queen's University in Kingston, Ontario.
Dr. Paterson disclosed that he has no relevant financial interests to disclose regarding this topic. CDDW is sponsored by the Canadian Association of Gastroenterology and the Canadian Association for the Study of the Liver.