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The journal «ONCOSURGERY» 2014, Vol.6, No 1

Screening for colorectal cancer in Tatarstan Republic

Starostina MA1, Afanasjeva ZA2, Hasanov RSh1, Borisov DA1, Nagumanov EV1, Gordeev MG1

1) Republican clinical oncological dispensary of Tatarstan Health Care,
2) Kazan State Medical Academy,
Kazan, Russia
Contact: Afanasieva Zinaida Aleksandrovna, e-mail:

The problem of colorectal cancer screening management is reviewed in the article.

Material and methods. In 2010 in Kazan we performed screening for colorectal cancer. This was preceded by promotion on republican tv for problem of colorectal cancer screening. The screening included 1071 persons, persons older than 45 were acceptable, persons with bleeding on that moment were excluded. There were 210 men with the mean age of 60.0±0.6 y.o., 861 women with the mean age of 59.1±1.1 y.o. As screening tests we used our developed questionnaires, digital rectal examination and hemoccult test Hexagon OBTI in all patients. The materials for study were fecal samples from 1071 persons. Fecal occult blood was determined using express-test Hexagon OBTI (HUMAN, Germany). The result was considered to be positive when two lines appeared. The sensitivity of questionnaires, digital rectal examination and also sensitivity, specificity and accuracy of Hexagon OBTI test wasassessed.

The statistical analysis was performed using software EXEL 8 and BIOSTATISTICA 4.03.

Results. According to questionnaires there were no complaints in 39% (413) of respondents. For patients with polyps 80% had no complaints. For digital rectal examination the lesions were detected in 822 (76.7%) persons, i.e. in every three of four persons who underwent screening. Rectal cancer was in 3 patients: in 1 – of stage I, in 1 – II, in 1 – of stage IV. Villous polyp was found in 4, tubular adenoma – in 10 persons. The sensitivity of questionnaires for colorectal cancer was 100%, the sensitivity of digital rectal examination for rectal cancer – 100%. According to questionnaires data colon cancer was suspected and proved in 1 patient. There was a IV stage of disease. The neglect of colorectal cancer determined by screening – 50%. The hemoccult test Hexagon OBTI was positive in all cases of rectal cancer, it et. the sensitivity of the test was 100%. Test was false-negative for colon cancer. The test was positive in 17 patients with hemorrhoid, in 1 – with rectal villous polyp and in 4 healthy persons. False-positive results of hemoccult test were in 22 (2.05%) persons. The descriptiveness of hemoccult test for colorectal cancer screening was as follows: sensitivity – 75%, specificity – 97.9%, accuracy – 97.9%.

Cocnclusion. Given high incidence rates of colorectal cancer in persons older than 45, high rates of neglect detected by screening and natural history of colon cancer we consider necessary to start screening from age of 35 and to use questionnaires, digital rectal examination and hemoccult test Hexagon OBTI as screening tests. For suspicion fiber-optic colonoscopy should be preformed. Screening for colorectal cancer should be preceded by awareness campaign for prevention and early diagnosis of this disease.

KEY WORDS: screening, cancer, rectum, colon, hemoccult test.


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