Colorectal Cancer Screening in a Spanish Town: Evaluation of Colonoscopy Preparation, Sedation by the Endoscopist and Screening Results

Abstract

Objective: The aim of this study is to evaluate the colonic cleansing preparation and colorectal cancer screening results in Sestao (Bilbao); and to verify the safety of endoscopist-controlled sedation. Materials and methods: A retrospective observational study of colorectal cancer screening using the immunological faecal occult blood test in a medium-risk population in this region, with colonoscopy being performed in the event of a positive result. The colonic cleansing preparation was administered in split doses; the second dose was administered 4 hours prior to colonoscopy. The quality of the preparation and lesion detection were evaluated. Sedation-related complications were analyzed. Results: Participation was high (4342 of 6896 people invited, 62.99%), with 309 subjects (7.12%) presenting a positive immunological faecal occult blood test. A high percentage of the 284 colonoscopies had optimal preparation: 276 (97.18%) had an adequate preparation. A total of 22 (7.91%) sedation-related complications were detected: only one (0.36%) was serious. A total of 140 high-risk adenomas were removed (47.13%) and 24 carcinomas were diagnosed (8.08%). Both these percentages are high. Conclusions: Split doses of colonoscopy preparation and reduction of the time interval between the second dose and the colonoscopy result in a high percentage of adequate preparation and lesion detection. Sedation by trained endoscopists is safe and effective. An immunological faecal occult blood test-based screening program is feasible and allows malignant and precancerous lesions to be efficiently detected and treated.