Thomas Imperiale, M.D., discusses his meta-analysis study of colon cancer screening in Latin America.
Transcript:
All the systematic review did was to say, “What kind of screening programs do they have?” Are they colonoscopy-based, or are they the so-called two-step where you do something noninvasive first, like a FIT test, and then for those who are positive with the FIT test, they have colonoscopy. So there were more programs, as you’d expect, that used FIT because it’s more economical than screening everybody
with colonoscopy. Yet, there were some that did use colonoscopy. They didn’t look long-term at the effect of the screening program because many of them may not be established long enough to be able to say something about reduced subsequent incidence of colon cancer and reduced death from colon cancer. So for that you need longitudinal studies.
Dr. Montalvan-Sanchez describes the prevalence in Latin America due to aging populations and changing diets.
Transcript:
Antes de nuestro trabajo, lo primero que no sabíamos es que en países de bajos ingresos y de pobres economías, no existe data, no existen datos en estos países. Eso es importante porque identifica lugares donde tenemos estratégicamente que buscar esta respuesta. Además, no sabíamos que el cáncer de colon era tan prevalente y que había tanto en Latinoamérica. Esto es por la occidentalización de la dieta; los estilos de vida han cambiado en Latinoamérica, y también nuestra población ha ido envejeciendo. Por lo cual ahora los números se comparan a los mismos que Podemos encontrar en economías como Estados Unidos o en Europa.
Dr. Imperiale says the outlook for screening programs in Latin America is good, based on the high uptake in these studies.
Transcript:
A first-time FIT positivity rate is around 7 to 8 percent. In these countries, I think it was closer to 11 to 13 percent. That’s really high. So, we are assuming that there were some symptomatic people in there whose only way to get care may have been to participate in these studies. It highlights the lack of programs, but it also, answers a question about if a program were established, could we expect it to do well? And I think the answer is yes. The uptake in these, low- to middle-income countries was high. I think 85 percent adherence to FIT testing, that’s really good. That’s higher than in the U.S.
Dr. Montalvan-Sanchez discusses FIT testing as an economical first line of screening for low-income countries.
Transcript:
¿Por qué es importante y cuál sería la ruta que debemos de tomar para exámenes de heces? Para exámenes de colonoscopía o heces. Creo que la ruta es tomar la muestras de heces, analizarlas, y sabiendo que después de que un resultado sea positivo, se va a necesitar una colonoscopía. Creo que en economías como las similares a las de mi país, que son considerados países de bajos ingresos, la ruta son exámenes de heces para colonoscopía. Igual, en economías
medias, también está la solución.
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