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IMPACT OF A COLORECTAL CANCER SCREENING PROGRAM IN THE SOUTHWESTERN OLTENIA REGION

Alexandra Georgiana Bocioaga 1, Costin Teodor Streba 1, Carmen Nicoleta Oancea 1, Tudorel Ciurea 1, Dan Ionuț Gheonea 1

Affiliations

1 University of Medicine and Pharmacy of Craiova, Craiova, Romania

Summary

AI Generated

A colorectal cancer screening program in southwestern Romania enrolled 44,714 individuals aged 50-75 years from November 2020 to April 2023, identifying 100 tumors and 1,992 polyps through fecal immunochemical testing and colonoscopy.

Of 38,610 individuals who received fecal immunochemical tests, 2,426 (6.28%) tested positive, and 1,262 colonoscopies were performed.
Among those who underwent colonoscopy, 862 patients had significant lesions including 100 tumors and 1,992 polyps, while 400 (31.7%) had negative findings.
Positive FIT results and positive colonoscopy findings both correlated with older age (p<0.05), and positive colonoscopy findings correlated with higher FIT values (p<0.05), but not with gender or geographic origin.
The program experienced 1,004 refusals (41.38% of positive FIT results), which the authors state demonstrates the need for an awareness campaign.
This material reports the first results of a large-scale CRC screening program in southwestern Romania and would be relevant to clinicians and public health professionals involved in population-based cancer screening initiatives.

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Abstract

Introduction

Colorectal cancer (CRC) is one of the most commonly diagnosed types of cancer worldwide, ranking as the third most common neoplasia and the second leading cause of cancer-related deaths according to Global Cancer Statistics 2020 [1]. In Romania, CRC has the highest incidence rate, as reported by the Globocan platform in 2020, although the mortality rate follows global trends. The growing incidence of colorectal cancer poses a significant challenge to the global healthcare system [2].

Aims & Methods

Our aims are to assess and demonstrate the importance and value of a CRC screening program in early diagnosis among individuals aged 50 to 75 years in the southwestern of Oltenia, Romania. We prospectively enrolled apparently healthy individuals between 50 and 75 years old in a CRC prevention program at the University of Medicine and Pharmacy of Craiova, in the southwestern Oltenia region. The ongoing program started in November 2020. Exclusion criteria included individuals already enrolled in a screening program for CRC, with a personal history of colonic polyps, colorectal cancer, or inflammatory bowel diseases and individuals with a family history of inherited syndromes linked with CRC. Patients were identified based on the lists provided by participating general practitioners. All provided informed consent and completed a questionnaire regarding symptoms and family history of CRC. Based on their responses, patients were either offered a fecal immunochemical test (FIT) followed by colonoscopy in case of a positive result or were directly referred for colonoscopy. Those with negative results were instructed to repeat the test in two years.

Results

Until 24 April 2023 we enrolled 44,714 individuals (18,415 male, 41.18%). Of these, 38,610 (86.34%) received FITs, of whom 2,426 (6.28%) had a positive finding and 49 were directly referred for colonoscopy based on their questionnaire answers. We performed 1,262 colonoscopies, also having 1,004 refusals (41.38% of positive FITs) and 209 (8.61%) in waiting. Percentage of positive FIT tests correlated with older age (p<0.05). The chance of a positive colonoscopy finding correlated with the FIT value (p<0.05) and older age (p<0.05), while not being linked to either gender or provenance. We did not find lesions in 400 subjects (31.7% negative colonoscopies). In total, we found 2,092 significant lesions in 862 patients: 100 tumors and 1,992 polyps.

Conclusion

We provided here the first results of a large-scale CRC screening program in the Southwestern region of Romania, proving the importance of a coherent early detection strategy in the successful management of digestive malignancies. The high rate of colonoscopy refusals shows the need for an awareness campaign involving all medical and allied health personnel.

References

1.Sung, Hyuna et al. “Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.” CA: a cancer journal for clinicians vol. 71,3 (2021): 209-249. doi:10.3322/caac.21660 .
2. Jiang, Yufei et al. “Global pattern and trends of colorectal cancer survival: a systematic review of population-based registration data.” Cancer biology & medicine, vol. 19,2 175–186. 6 Sep. 2021, doi:10.20892/j.issn.2095-3941.2020.0634.

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Care of psychiatric patients during endoscopic treatment of repeated foreign body ingestions

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Care of psychiatric patients during endoscopic treatment of repeated foreign body ingestions

Karolien Haenebalcke 1

Affiliations

1 None, None, Belgium

Summary

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Abstract

Event

UEG Week Barcelona 2026

Topics

Nurses

Session

Patient care: Requirements for special patient groups

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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When brushing teeth becomes a challenge: Foreign body removal

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When brushing teeth becomes a challenge: Foreign body removal

Arianna Parrella 1

Affiliations

1 Ramazzini Hospital, Carpi, Italy

Summary

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Abstract

Event

UEG Week Barcelona 2026

Topics

Nurses

Session

ESGENA: Our most memorable cases

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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Education of endoscopy nurses in Europe – 30 years and still not standardised

Ulrike Beilenhoff 1

Affiliations

1 ESGENA Scientific Secretary, Ulm, Germany

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Abstract

Event

UEG Week Barcelona 2026

Topics

Nurses

Session

Education of patients and staff

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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The guide to infection-free endoscopy in UZ Ghent

Thalita Vanhullen 1

Affiliations

1 None, None, Belgium

Summary

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Abstract

Event

UEG Week Barcelona 2026

Topics

Nurses

Session

Green endoscopy and hygiene

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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Bacterial consortia

Harry Sokol 1

Affiliations

1 Saint-Antoine Hospital, Paris, France

Summary

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Summary is not available for this content yet.

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Abstract

Event

UEG Week Vienna 2024

Topics

Gut Microbiota Mechanisms & Personalised Medicine

Session

Future microbiome therapeutics

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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SINGLE USE DUODENOSCOPES ARE COMPARABLE TO REUSABLE DUODENOSCOPES WITH DISPOSABLE END CAP: AN INTERNATIONAL, MULTICENTER STUDY

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

SINGLE USE DUODENOSCOPES ARE COMPARABLE TO REUSABLE DUODENOSCOPES WITH DISPOSABLE END CAP: AN INTERNATIONAL, MULTICENTER STUDY

Marina Kim 1, Romy Bareket 2, Andrew Canakis 3, Monica Gaidhane 4, Amy Tyberg 5, Avik Sarkar 4, Enrique Vazquez Sequeiros 6, Miguel Puga-Tejada 7, Jorge Baquerizo-Burgos 8, Carlos Robles-Medranda 8, Carlos Robles-Medranda 8, Martha Graciela Arevalo Mora 8, Michel Kahaleh 9, Carlos Robles-Medranda 10, Haroon Shahid 4, Michel Kahaleh 4

Affiliations

1 St.Louis University, St. Louis, United States

2 Robert Wood Johnson University Hospital, New Brunswick, United States

3 University of Maryland Medical System, Baltimore, United States

4 Robert Wood Johnson Medical School Rutgers University, New Brunswick, United States

5 Rutgers Robert Wood Johnson, New Brunswick, United States

6 Hospital Ramon y Cajal Unidad de Medicina Tropical, Madrid, Spain

7 Instituto Ecuatoriano de Enfermedades Digestivas, Guayaquil, Ecuador

8 Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador

9 NYU Langone, Mineola, United States

10 Instituto Ecuatoriano De Enfermedades Digestivas (IECED) -University Hospital Omni, Guayaquil, Ecuador

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Abstract

Introduction

Multi-drug resistant organism (MDRO) infections have become a significant concern associated with the use of reusable duodenoscopes, even with stringent sterilization protocols. As a result, various modalities have been developed to reduce the risk of cross-contamination. However, limited data exist that directly compare these different approaches. The aim of this study was to compare the efficacy and operator usability of two different modalities: single-use disposable duodenoscopes (SDDs) and reusable duodenoscopes with disposable end caps, in performing ERCP procedures. The use of disposable duodenoscopes has gained interest as an alternative to standard reusable duodenoscopes due to their potential to reduce the risk of MDRO infections. Nevertheless, the efficacy and operator usability of these devices in comparison to reusable duodenoscopes with disposable end caps have not been fully evaluated.

Aims & Methods

A multi-center retrospective study was conducted to evaluate the efficacy and usability of a single-use disposable duodenoscopes (SDD) and reusable duodenoscopes with disposable end caps in performing ERCP procedures. The study included patients who underwent ERCP using either the SDD or the reusable duodenoscope with disposable end cap, with each procedure performed by an expert endoscopist from one of four academic centers.The primary outcome measures included technical success rate, procedural complexity, completion of ERCP with the device, and adverse events. In addition, the endoscopists rated the devices on a scale of 1 (easy) to 5 (severely difficult) for location and visualization quality, maneuverability based on papillary orientation, suction/air control, and elevator efficiency.

Results

The study included 158 patients, with 56 undergoing ERCP using a SDD (mean age 60, 54% male) and 102 using the standard reusable duodenoscope with a disposable end cap (mean age 59, 41% male) (Figure 1 & 2). The technical success rate was 98% for both groups, and the procedural complexity of the ERCP cases performed was graded as follows: Grade 1 (15%), Grade 2 (36%), Grade 3 (32%), and Grade 4 (17%). Two patients (4%) in the SDD group required conversion to a reusable duodenoscope, while none in the disposable end cap group did. Endoscopists rated the SDD and disposable end cap on a scale of 1 (easy) to 5 (severely difficult) for location and visualization quality (2.08 vs 1.12), maneuverability based on papillary orientation (1.29 vs 1.01), suction/air control (1.47 vs 1.00), and elevator efficiency (1.92 vs 1.08). Overall, most endoscopists considered both options comparable to their reusable counterparts.

Conclusion

In conclusion, the study showed that the single use duodenoscope and the reusable duodenoscope with a disposable end cap had comparable efficacy in performing ERCPs of varying complexity. Although operator usability was slightly better with the reusable duodenoscope and disposable end cap combination compared to the SDD, both were considered comparable to standard reusable duodenoscopes. With ongoing technological advancements, these alternative modalities can further improve in functionality, reduce the risk of multi-drug resistant organism (MDRO) cross-contamination, and serve as viable alternatives to standard reusable duodenoscopes.

Event

UEG Week Copenhagen 2023

Topics

Endoscopy Hepatobiliary

Submission format

Abstract

Session

Hepatobiliary endoscopy: Old procedure, new approach

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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