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      Impacto de un programa de cribado poblacional basado en detección de sangre oculta en heces sobre el manejo quirúrgico del cáncer colorrectal Translated title: Impact of a population screening program based on fecal occult blood detection on the surgical management of colorectal cancer

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          Abstract

          Resumen Objetivo principal: comparar los pacientes intervenidos de CCR (Cáncer colorrectal) en el contexto de un programa de cribado poblacional versus aquellos diagnosticados por presentar síntomas. Metodología: estudio longitudinal retrospectivo. Se estudiaron dos cohortes de pacientes intervenidos de CCR en el Hospital Clínico de Barcelona (2010-2012) procedentes del Programa de detección precoz de CCR de Barcelona (n=59), y de Urgencias o de Consultas Externas por presentar sintomatología (n=118). Resultados principales: Los del grupo cribado presentaron con mayor frecuencia tumores en estadio precoz (estadios I-II) que el grupo síntomas (57,6% vs 23,7%; p<0,001). La necesidad de uso de ostomía, y la estancia hospitalaria fue superior en el grupo síntomas (36,4% vs 10,2%; p=0,001; 10,1 días vs 7,1 días; p<0,001. Conclusión principal: los pacientes con CCR diagnosticados en el contexto de programas de cribado presentan un estadio más precoz, menor estancia hospitalaria y menor necesidad de ostomías. El programa de cribado poblacional presenta beneficios para los pacientes y el sistema sanitario.

          Translated abstract

          Abstract Objective: the comparison of patients diagnosed in a screening program versus those diagnosed by symptoms has not been studied in depth. The aim of this study is to compare patients diagnosed with CRC in the context of a population-based screening program and those diagnosed only by symptoms. Methods: longitudinal retrospective study in which two cohorts of patients with CRC are compared between 2010 and 2012 at Hospital Clinic de Barcelona depending on the method of diagnosis. Fifty-nine patients diagnosed by the cancer screening programme of Barcelona were compared with 118 patients diagnosed only by symptoms at the emergency room or outpatient clinic. Results: Patients in the screened group presented more frequently tumors in the early stage (stages I-II) compared with the symptom group (57.6% vs. 23.7%, p <0.001). The need for ostomy was higher in the symptom group, (36, 4% vs 10,2%, p = 0.001). Hospital stay was higher in the group diagnosed only by symptoms (10.1 days vs 7.1 days, p <0.001). Conclusions: Patients with CRC diagnosed in the context of screening programmes have an earlier stage, shorter hospital stay and less need for ostomy. In conclusion, the population screening program, beyond the reduction of delayed diagnosed and mortality, directly benefits CRC patients and decreases Hospital costs.

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          Cancer incidence in Spain, 2015.

          Periodic cancer incidence estimates of Spain from all existing population-based cancer registries at any given time are required. The objective of this study was to present the current situation of cancer incidence in Spain.
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            Colorectal cancer screening: Recommendations for physicians and patients from the U.S. Multi-Society Task Force on Colorectal Cancer

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              Guía de práctica clínica. Diagnóstico y prevención del cáncer colorrectal. Actualización 2018

              This document updates the recommendations made by the Spanish Society of Family and Community Medicine and the Spanish Association of Gastroenterology for the diagnosis and prevention of colorectal cancer (CRC). In order to evaluate the quality of the evidence and determine the recommendation levels of the interventions, we used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. This document establishes optimal delay intervals based on symptoms and the faecal immunochemical test (FIT) and recommends reducing the barriers for diagnostic confirmation in symptomatic subjects. With regard to CRC screening in the average-risk population, we propose strategies to achieve the universal implementation of organised CRC screening programmes based on biennial FIT and to increase the participation of the target population, including the involvement of Primary Healthcare. This Clinical Practice Guideline recommends universal screening for Lynch syndrome with mismatch repair proteins immunohistochemistry or microsatellite instability in incident CRCs and the use of gene panels in patients with adenomatous polyposis. It also updates the strategies to reduce the incidence and mortality of both CRC and other tumours associated with hereditary syndromes. Regarding non-hereditary familial CRC and surveillance after resection of adenomas, serrated lesions or CRC, we established the recommendations based on the attributable risk and the risk reduction of the proposed intervention. Finally, the document includes recommendations regarding surveillance intervals in inflammatory bowel disease and the attitude towards dysplasia.
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                Author and article information

                Journal
                index
                Index de Enfermería
                Index Enferm
                Fundación Index (Granada, Granada, Spain )
                1132-1296
                1699-5988
                September 2019
                : 28
                : 3
                : 115-119
                Affiliations
                [2] orgnameHospital Clínic de Barcelona orgdiv1Institut de Malalties Digestives i Metabòliques orgdiv2Servicio de Gastroenterología España
                [1] orgnameHospital Clínic de Barcelona orgdiv1Institut de Malalties Digestives i Metabòliques orgdiv2Servicio de Cirugía Gastrointestinal España
                Article
                S1132-12962019000200005 S1132-1296(19)02800300005
                d2d5b998-7046-432b-a6e1-ef991b616328

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 20 December 2018
                : 18 October 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 5
                Product

                SciELO Spain

                Categories
                Originales

                Cribado,Estadificación,Supervivencia,Cirugía,Cáncer Colorrectal,Screening,Staging,Survival,Surgery,Colorectal cancer

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