Rastreio endoscópico do cancro colorrectal. Experiência de dois anos

J. Cotter (1),(2), S. Lima (1),(2), S. Barroso (1),(2), C. Marinho (1), P. Moutinho (1), A. Rodrigues (1), L. Alberto (1), M. J. Moreira (1),(2), L. Lobo (1)

 

 

Resumo

Os métodos endoscópicos são considerados a forma mais válida de rastreio do cancro colorrectal e, como tal, métodos que devem ser utilizados caso haja disponibilidade de recursos. Apresenta-se uma análise retrospectiva da actividade de uma Unidade de Rastreio do Cancro do Cólon referente a um período de 24 meses, respeitante ao rastreio efectuado por colonoscopia (76,1%) e sigmoidoscopia flexível (23,9%) em 2700 indivíduos. Foi diagnosticado cancro colorrectal em 1% dos casos e pólipos adenomatosos em 38%, sendo 16,1% destes de risco (dimensões > 1 cm). Cerca de 89% das neoplasias malignas e 71 % dos pólipos localizavam-se no recto e sigmoide, consequentemente acessíveis à sigmoidoscopia flexível. Conclui-se que em face dos resultados encontrados, o rastreio endoscópico do cancro colorrectal deve ser implementado devido à sua eficácia diagnóstica e possibilidades terapêuticas (nomeadamente polipectomia), de preferência por colonoscopia e quando este método não estiver disponível, por sigmoidoscopia flexível.

 

 

Summary

Endoscopic methods are a precious and valid tool for colorectal cancer screening; therefore they should be embraced if resources are available. The authors present a retrospective analysis of a Colorectal Cancer  Screening Unit during a 24 month period, using colonoscopy (76,1%)and flexible sigmoidoscopy (23,9%) envolving 2700 patients. Colorectal cancer was diagnosed in 1% of the patients and polyps in 38%, 16,1% of these had increased risk (size >1cm). Near eighty nine per cent of malignant neoplasic lesions and 71% of the polyps were located in the rectum and sigmoid cólon, therefore detectable by flexible sigmoidoscopy. These results support the implementation of endoscopic screening of colorectal cancer because of its diagnostic effectiveness and therapeutic possibilities (namely polipectomy). When resources are available, colorectal cancer screening should be preferably performed by colonoscopy and if not, by flexible sigmoidoscopy.

 

 

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(1) Unidade de Rastreio do Cancro do Cólon (Santa Casa da Misericórdia de Guimarães)

(2) Hospital da Senhora da Oliveira – Guimarães (Serviço de Gastrenterologia)

Correspondência:

José Cotter

Hospital da Senhora da Oliveira – Guimarães

Serviço de Gastrenterologia

Rua dos Cutileiros – Creixomil

4800- 055 Guimarães

 

Recebido para publicação: 18/05/2008

Aceite para publicação: 14/08/2008