Background/Aim: The aim of the present study was to compare fecal immunochemical tests (FITs) for colorectal cancer (CRC) screening with the traditional guaiac-based FOB tests (gFOBT). Materials and Methods: A cohort of 368 colonoscopy-referral patients were evaluated by i) the new-generation FIT: ColonView quick test (CV; Biohit Oyj, Finland) and ii) a conventional gFOBT HemoccultSENSA (HS; Beckman Coulter, USA). Three fecal samples were requested for both assays, and all subjects underwent diagnostic colonoscopy with biopsy confirmation. Sensitivity (SE), specificity (SP), positive predictive value (PPV), negative predictive value (NPV) and area under curve (AUC) were calculated for both tests using three endpoints: adenoma (A), advanced adenoma (AA) and adenocarcinoma (AC). Results: Colonoscopy and biopsies disclosed normal mucosa in 90/378 (24.5%) subjects, early A in 108/368 (29.3%) cases, AA in 48/368 (13.0%) and AC in 37/368 (10.1%), and non-neoplastic conditions in the remaining 85 (30.3%). For the AC endpoint, the CV (Hb/Hp) test had 94.6% SE and 65.1% SP (AUC=0.799), while the HS test had SE of 75.7% and SP of 84.3% (AUC=0.800). For the A endpoint, the difference between CV and HS was even more pronounced; SE of 44.2% and 19.2%, respectively (p<0.0001). Hb and Hb/Hp complex of the CV test showed equal performance for all endpoints. Conclusion: Sensitivity (94.6%) of the ColonView quick test for the most reproducible endpoint (invasive CRC) far exceeded the pooled sensitivity (79%) estimated in a recent meta-analysis for 8 common FIT brands. As shown in a previous study, ColonView quick test is superior in SE to HemoccultSENSA test, making CV a perfect FIT for organized CRC screening. Colorectal cancer (CRC) is the third most common malignancy, with over 1.3 million new cases and over 600.000 annual deaths worldwide in 2012 (1). In Brazil, the incidence of CRC remains lower than in many high-income countries, but mortality is similar, reflecting an incidence-tomortality ratio disparity in Brazil (2-4). CRC is readily suitable for organized screening, offering a possibility for both early detection and cancer prevention, with reduced mortality rates (5, 6). The majority of CRC develops from precursor lesions, i.e., adenoma, and several studies have estimated the accuracy of screening methods also for advanced adenomas. Effective CRC screening can achieve both the primary and secondary prevention, by detecting cancer precursors (polyps, adenomas) and early cancers, respectively (7, 8).

Dear Editor: Chronic radiation proctopathy (CRP) is the most frequent radiotherapy complication of patients with pelvic malignancies, occurring in 5-20 % of cases. CRP is characterized by endothelial dysfunction, microvascular injury with ischemia, tissue fibrosis, and telangectasias, leading frequently to rectal bleeding. Argon plasma coagulation (APC) has been the preferred modality of invasive treatment for most of these patients presenting rectal bleeding due to its accessibility, effectiveness, and low risk of complications. APC is a non-contact coagulating method that uses a high-frequency electrosurgically ionized argon gas for tissue coagulation within 0.5 to 3 mm of deepness. The APC-related complications seem to be associated to higher argon flow rates and power settings. Our previous experience in the treatment of CRP with APC at 40-50 power and 2.0-2.5 L/min was associated with high rates of complications including deep and large rectal ulcers. Based in ex vivo experiments, it has been suggested that APC treatment was optimal at a power of 40 W and a gas flow rate at a 1.2 L/ min. However, there is still no consensus on the optimal settings of electric power and argon gas flow rate. Therefore, the aim of this study was to compare the efficacy and safety of two different settings of APC in the treatment of CRP (40 W power and 1.2 L/min versus 40-50 power and 2.0-2.5 L/min).