oa Emerging role for colorectal cancer screening in Qatar

Introduction Colorectal cancer (CRC) is increasing in incidence in several Asian countries but screening programs are lacking. In Qatar, ,we embarked on a pilot study for Colo-Rectal Cancer (CRC) screening based at 3 primary health centers among subjects with average risk for colorectal cancer. Aim To devise a national screening program for the early detection of colonic cancer among persons at average risk for Colorectal cancer (CRC) ,based on the outcome of our pilot study Methods All subjects aged 40-74 years at average risk for CRC ie that is individuals without history of polyps or documented cancer or inflammatory bowel disease in the past and absent family history are included. They are subjected to screening by immunochemical fecal occult blood testing at the primary health centers. Subjects positive for stool occult blood undergo total colonoscopy at the tertiary care hospital. Cancers and polyps picked up are documented and subjected to appropriate investigations and therapy Results A total number of 1242 healthy subjects at average risk for CRC, between ages of 40-74 years underwent stool occult blood testing by immunochemical fecal occult test. 57 (4.5%)were found to be positive and referred for colonoscopy. Of the 57 eligible persons, invited for colonoscopy, 32(56.4%) underwent the procedure , of whom 7 had polyps and 5 patients had cancer or advanced adenoma. Conclusions Cancers and adenomatous polyps which are treatable and curable can be successfully picked up by primary care level screening programs. Relevance, feasibility and cost effectiveness of such screening programs in Middle East has to be confirmed by community based programmatic screening studies in our region