Antoni Castells Presentation

42 Pages·2013·2.77 MB·English

Population-based
CRC screening:
the FIT approach
Dr Antoni Castells
Director of the Institute of Digestive
Disease, The Hospital Clinic
Barcelona, Spain
5-6 July 2013, Barcelona
Population-based CRC
screening: the FIT approach
Antoni Castells, MD, PhD
Gastroenterology Department
Hospital Clínic, Barcelona
([email protected])
Colorectal cancer prevention
Tertiary prevention
Primary prevention (surveillance)
Secondary prevention
(screening)
Normal
Adenoma Carcinoma
mucosa
Colorectal cancer: epidemiology
Piñol et al. JAMA 2005
CRC prevention: risk stratification
Factores de
No Si
riesgo personal
y/o familiar
Factor de riesgo familiar Factor de riesgo personal
Edad
< 50 años ≥≥≥≥ 50 años
PAF CCHNP CCR Adenoma Enfermedad
familiar inflamatoria
intestinal
Cribado
Abstención
Cribado Cribado Vigilancia Vigilancia
Cribado
Colorectal cancer screening:
average-risk population
s 500
t
n
a
t 400
i
b
a
h
n 300
i

0
0
0 200
.
0
0
1
100
/

e
t
a
R 0
20-24 30-34 40-44 50-54 60-64 70-74 80-84
Age (years old)
Conditions for a population-based
screening (Frame and Carlson, 1975)
(cid:1)
Relevant health care problem
(cid:1) (cid:2)(cid:2)(cid:2)(cid:2)
Well-established natural history early
detection diminishes morbi-mortality
(cid:1)
Effective and well-accepted treatment
(cid:1)
Adequate screening test
(cid:1)
Cost-effective strategy
Cancer incidence in Spain
Colorrectal 25.665
Pulmón 18.821
Mama 15.979
Vejiga 14.477
Próstata 13.212
0 5.000 10.000 15.000 20.000 25.000 30.000
Casos nuevos /año
Centro Nacional de Epidemiología
CRC mortality in Spain
EUROCARE 4
Natural history of CRC
5 years 5 years
Normal
Adenoma Carcinoma
mucosa
AAddvvaanncceedd aaddeennoommaa::
•• SSiizzee (cid:1)(cid:1)11 ccmm
•• VViilllloouuss ccoommppoonneenntt
•• HHiigghh--ggrraaddee ddyyssppllaassiiaa