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Need for Saudi Arabian colorectal cancer screening program unclear
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The applicability of a colorectal cancer screening program in Saudi Arabia should be addressed, but researchers were unable to determine the optimal age at which screening should be initiated, according to recent study data.
Researchers studied 2,654 patients aged 18 to 109 years (mean age, 50.5 years; 57.7% women) who underwent colonoscopy from August 2007 to April 2012 at a university hospital in Riyadh, Saudi Arabia. Using data collected retrospectively, they determined baseline polyp and adenoma prevalence in a cohort representative of the general population in an attempt to clarify the efficacy of a national colorectal cancer (CRC) surveillance program.
Information included patients’ age, sex, symptoms, indication for colonoscopy, quality of bowel preparation, medication history and comorbidities. Characteristics of the procedure (sensitivity, specificity, likelihood ratios, receiver operating characteristic curve and area under the curve) were used to determine optimal cut-off age for CRC screening program initiation.
The polyp detection rate in 2,542 completed colonoscopies was 20.8% (95% CI, 19.2-22.5), adenoma detection rate was 8.1% (95% CI, 7.1-9.1), and advanced adenoma detection rate was 0.5% (95% CI, 0.2-0.7). The mean adenoma prevalence varied between age-stratified groups, ranging from 6.2% (patients aged 40 to 44 years) to 13.6% (aged older than 65 years). Ultimately, age was not predictive of adenoma incidence (AUROC=59%). Researchers were unable to determine an optimal age at which CRC screening would be beneficial, in part, they said, because of a percentage of young patients who had adenomas.
“Although the proportion of those who had screening as an indication for colonoscopy in our cohort was low [7.7%],” wrote the researchers, “this study sheds some light on the prevalence of adenomas in those undergoing colonoscopies for various indications as well as opportunistic screening, and adds to the data that would determine if screening for CRC is a need and would be efficacious in Saudi Arabia.”
Disclosure: The researchers report no relevant financial disclosures.
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