EVALUATION OF THE DETECTION RATE OF ADENOMA AND ADENOCARCINOMA IN A POPULATION-BASED COLORECTAL CANCER SCREENING PROGRAM IN THE MUNICIPALITY OF CAIRU, BAHIA

Introduction In Brazil, colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related death. The resection of precursor lesions and early diagnosis impact its natural history, which makes population-based screening recommended. The quantitative fecal immunochemical test (FIT) is the preferred method for non-invasive screening, and colonoscopy is the chosen endoscopic method.

Objective The aim of this study is to determine the detection rate of adenomas and adenocarcinomas in the studied population subjected to a population-based CRC screening program in the municipality of Cairu, Bahia.

Method An observational study was conducted, with data collected from the service records of the population-based CRC screening program in Cairu, Bahia, during the first half of 2023. Residents aged 50 to 75 were subjected to FIT. Patients with FIT results above 25 ng/ml (considered positive) were referred for colonoscopy. The specimens from resections were sent for histopathological study.

Results FIT results from 1,724 people were analyzed, with 951 (55%) being women. The average age of participants was 58.32 years. A total of 165 people (9.6%) had a positive FIT result. Of these, 122 underwent colonoscopy, 58% were women, and the average age was 58.8 years. A total of 144 lesions were identified in 41% of the examinations, with an average of 1.1 lesions per exam. Of these, 141 (97.91%) were resected and classified according to the Paris classification. Among the three lesions that were not resected, all were located in the rectum: one had a subepithelial appearance measuring 3.5 cm, one was a NG-LST type lesion of 16 mm, and there was a hyperplastic polyp confirmed by artificial intelligence. The subepithelial lesion was treated with transanal video-assisted surgery (D-Port platform), with a histopathological diagnosis of neuroendocrine tumor. The second lateral growth lesion was resected transanally (histopathology: hyperplastic). Dysplastic lesions were present in 41 of the 122 exams performed (33% of the sample). Histopathology results of these resected lesions revealed a total of 82 premalignant lesions (58.15%), of which 78 were adenomatous and 4 were serrated lesions. There were 58 benign lesions (41.13%). One lesion (0.72%) was identified as adenocarcinoma.

Conclusion Individuals with a positive FIT result who underwent screening colonoscopy showed high detection rates of adenomas and adenocarcinomas, similar to those reported in the literature. This highlights the importance of population-based CRC screening programs.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025