Digestive and Liver Disease - Volume 48 - Supplement 2 - February 2016

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e172 Abstracts of the 22nd National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
P.09.2
COLORECTAL CANCER SCREENING: PRELIMINARY DATA FROM
THE CASERTA AREA
Iuliano D.*1, Miranda A. 1, Bile G.2, Zingone F.2, Mauro B.1,
Sorrentini I.3 , De Colibus P.1, Trovato C.2, Fontana A.2, Crispino A.2,
Fascione A.4, Agozzino L.5, Di Benedetto G.5, Esposito S.5,
Santarsiere A.5, Tari M.G.6, Bottiglieri M.E.1
1UOC Gastroenterologia ed endoscopia digestiva, PO Marcianise,
ASL CE, Caserta, Italy, 2UOSD Endoscopia Digestiva PO Aversa, ASL
CE, Caserta, Italy, 3UOCMedicina P.O.S. Rocco Sessa Aurunca, ASL CE,
Caserta, Italy, 4UOC Patologia Clinica PPOO Maddaloni-Marcianise, ASL
CE, Caserta, Italy, 5UOC Anatomia Patologica, ASL CE, Caserta, Italy,
6Servizio controllo interno di gestione, ASL CE, Caserta, Italy
Background and aim: Italian epidemiological data on colorectal
cancer screening programs described a 5.2% of subjects with positive
fecal occult blood test (FOBT) in the general population. The same
data reported that 80% of these subjects underwent colonoscopy.
The cancer detection rate was 2.2 per 1000 people and the detection
rate for advanced adenomas was 0.3 per 1000. The aim of our study
was to compare the national data to those of the Caserta area in the
first 18 months of the screening.
Material and methods: Between January 2014 and August 2015,
70,21% (n=225.907) of eligible 321.765 people who lived in Caserta
and aged 45-75 years, were invited to participate in the national
population-based screening program. The subjects who agreed to
participate received a guaiac-based FOBT and those with positive
test were invited to undergo full colonoscopy.
Results: Of the 225.907 participants invited for the screening,
15.08% (n=34.060) agreed to undergo FOBT that resulted positive in
8,08% (n=2.717). Actually, 52,52% (n=1324) of FOBT-positive subjects
performed colonoscopy. Colorectal cancer (n=102) was found in
7.7% of FOBT-positive subjects. High grade dysplasia adenomas
(n=495) and lower grade dysplasia adenomas (n=219) were found
in 37,4% and 16,5.% of FOBT positive subjects respectively, whereas
in 22% of those investigate other abnormalities (hyperplastic polyps,
diverticular disease, inflammatory bowel diseases) were recorded as
being present. The cancer detection rate was 3.1 per 1000 people
and the detection rate for advanced adenomas was 15 per 1000.
Conclusions: Despite a lower percentage of people who agreed to
undergo colonoscopy in our area we found a higher rate of cancers
and advanced adenomas compared to the national data. Our results
suggest the necessity to continue the screening and increase the
awareness of colorectal cancer screening program and its benefits
amongst the general population.
P.09.3
COLORECTAL CANCER SCREENING IN EARLY AGE: PRELIMINARY
DATA FROM THE CASERTA AREA
Iuliano D.*1, Miranda A. 1, Bile G.2, Zingone F.2, Mauro B.1,
Sorrentini I.3 , De Colibus P.1, Trovato C.2, Fontana A.2, Crispino A.2,
Fascione A.4, Agozzino L.5, Di Benedetto G.5, Esposito S.5,
Santarsiere A.5, Tari M.G.6, Bottiglieri M.E.1
1UOC Gastroenterologia ed endoscopia digestiva, PO Marcianise,
ASL CE, Caserta, Italy, 2UOSD Endoscopia Digestiva PO Aversa, ASL
CE, Caserta, Italy, 3UOCMedicina P.O.S. Rocco Sessa Aurunca, ASL CE,
Caserta, Italy, 4UOC Patologia Clinica PPOO Maddaloni-Marcianise, ASL
CE, Caserta, Italy, 5UOC Anatomia Patologica, ASL CE, Caserta, Italy,
6Servizio controllo interno di gestione, ASL CE, Caserta, Italy
Background and aim: Several randomized trials suggest that
screening for colorectal cancer using guaiac-based fecal occult blood
test (FOBT) reduces mortality by 25% in people who undergo the
screening. Generally, only people aged 50-74 years are invited. The
aim of our study was to evaluate preliminary data on the effects
of FOBT-based colorectal cancer screening in subjects aged 45-49
years.
Material and methods: Between January 2014 and August 2015,
70,21% (n=225.907) of a total of 321.765 eligible people living in
Caserta and aged 45-75 years were invited to participate in the
national population-based screening program. The subjects who
agreed to participate received a guaiac-based FOBT and those with
positive test were invited to undergo full colonoscopy.
Results: Among the subjects who accepted to undergo FOBT, 3017
(1.33%) were aged 45-49 years. The FOBT resulted positive in 151
(5%) of this age-group, while 23.1% (n =35) of the FOBT-positive
subjects underwent colonoscopy. Colorectal cancer was found
in three people aged 45-49 years (8.57%); high grade dysplasia
adenomas and low grade dysplasia adenomas were found in 9.27%
(n=14) and 4.63% (n=7), respectively. Other diseases were reported
in 16% of this age group (hyperplastic polyps, diverticular disease,
and inflammatory bowel diseases). Cancer detection rate was 1 per
1000 screened people, while detection rate for advanced adenomas
was 4.6 per 1000.
Conclusions: We found a low rate of FOBT positive subjects in
the 45-49 age-group, with most of the individuals who agreed
to undergo colonoscopy being positive for any lesions. However,
a higher numbers of screening in this age group is needed to
understand the real benefit of including these subjects in a national
screening program.
P.09.4
THREE-DIMENSIONAL HIGH-RESOLUTION ANORECTAL
MANOMETRY AND RECTOANAL DELTA CONTRACTILE INTEGRAL
FOR THE ASSESSMENT OF FUNCTIONAL DEFECATORY DISORDERS:
TOY OR TOOL?
Gambaccini D.*, Bellini M., De Bortoli N., Russo S., Zari M.,
Martinucci I., Ricchiuti A., Surace L., Costa F., Mumolo M.G.,
Marchi S.
Azienda Ospedaliera Universitaria Pisana, Gastroenterologia
Universitaria, Pisa, Italy
Background and aim: Conventional water perfused manometry
(WPM) identifies functional defecatory disorders (FDD) according to
the defecatory patterns suggested by Rao. Unfortunately, manometric
data often conflictg with clinical data, and the balloon expulsion
test (BET) or defecography need to be performed to reach a correct
diagnosis. High resolution anorectal manometry (HRAM) and three-
dimensional HRAM (3D-HRAM) enable a better evaluation of the
endoanal and endorectal pressure and the anorectal dynamics, thus
providing better diagnostic accuracy. On the basis of the indexes
used by esophageal high resolution manometry we identified a new
parameter potentially useful for the evaluation of FDD: the Recto-
Anal Delta-Contractile Integral (RAD-CI). The aim of the study was to
evaluate: 1) the possible correlation between WPM and 3D-HRAM
parameters 2) the anorectal dynamics using RAD-CI and its possible
correlation with BET.
Material and methods: Twenty-one FDD (mean age 54.8 ± 17.9
yrs.;12F), diagnosed by using WPM, BET and/or defecography (15
type I, 6 type II), underwent 3D-HRAM (Manoscan 360TM, Medtronic
- USA). Endoanal and endorectal pressure values obtained during
the push straining were used to calculate the contractile integral
(CI), which is a measure of duration and intensity. Endoanal CI was
evaluated on a space including the anal canal for the whole duration
of the push straining. By using the function “isobaric contour”,
pressures lower than mean resting pressure of the anal canal were
excluded. Endorectal CI was calculated on a 10 mm space for the
whole duration of push straining. RAD-CI was the difference between
endoanal CI (proportionally correlated to 10 mm) and endorectal CI.