Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2016; 8(8): 629-634
Published online Aug 15, 2016. doi: 10.4251/wjgo.v8.i8.629
Academic hospital staff compliance with a fecal immunochemical test-based colorectal cancer screening program
Georgia Vlachonikolou, Paraskevas Gkolfakis, Athanasios D Sioulas, Ioannis S Papanikolaou, Anastasia Melissaratou, Giannis-Aimant Moustafa, Eleni Xanthopoulou, Gerasimos Tsilimidos, Ioanna Tsironi, Paraskevas Filippidis, Chrysoula Malli, George D Dimitriadis, Konstantinos Triantafyllou
Georgia Vlachonikolou, Paraskevas Gkolfakis, Athanasios D Sioulas, Ioannis S Papanikolaou, Anastasia Melissaratou, Giannis-Aimant Moustafa, Eleni Xanthopoulou, Gerasimos Tsilimidos, Ioanna Tsironi, Paraskevas Filippidis, Chrysoula Malli, George D Dimitriadis, Konstantinos Triantafyllou, Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, University of Athens, 12462 Athens, Greece
Author contributions: Vlachonikolou G searched the literature, drafted and finally approved the manuscript; Gkolfakis P analyzed the data, reviewed the draft and finally approved the manuscript; Sioulas AD, Papanikolaou IS, Malli C and Dimitriadis GD made critical revisions, reviewed the draft and finally approved the manuscript; Melissaratou A, Moustafa GA, Xanthopoulou E, Tsilimidos G, Tsironi I and Filippidis P collected the data, reviewed the draft and finally approved the manuscript; Triantafyllou K conceived the idea, designed the study, reviewed the statistical methods and the draft and finally approved the manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the “Attikon” University General Hospital.
Informed consent statement: All individuals that participated in the study provided their written informed consent prior to study enrollment.
Conflict-of-interest statement: None to declare.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Athanasios D Sioulas, MD, PhD, Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, University of Athens, 1 Rimini Street, 12462 Athens, Greece. athsioulas@yahoo.gr
Telephone: +30-210-5832090 Fax: +30-210-5326422
Received: February 23, 2016
Peer-review started: February 24, 2016
First decision: April 15, 2016
Revised: April 26, 2016
Accepted: June 2, 2016
Article in press: June 2, 2016
Published online: August 15, 2016
Abstract

AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer (CRC) screening program using fecal immunochemical test (FIT).

METHODS: All employees of “Attikon” University General Hospital aged over 50 years were thoroughly informed by a team of physicians and medical students about the study aims and they were invited to undergo CRC screening using two rounds of FIT (DyoniFOB® Combo H, DyonMed SA, Athens, Greece). The tests were provided for free and subjects tested positive were subsequently referred for colonoscopy. One year after completing the two rounds, participants were asked to be re-screened by means of the same test.

RESULTS: Among our target population consisted of 211 employees, 59 (27.9%) consented to participate, but only 41 (19.4%) and 24 (11.4%) completed the first and the second FIT round, respectively. Female gender was significantly associated with higher initial participation (P = 0.005) and test completion - first and second round - (P = 0.004 and P = 0.05) rates, respectively. Phy

sician’s (13.5% vs 70.2%, P < 0.0001) participation and test completion rates (7.5% vs 57.6%, P < 0.0001 for the first and 2.3% vs 34%, P < 0.0001 for the second round) were significantly lower compared to those of the administrative/technical staff. Similarly, nurses participated (25.8% vs 70.2%, P = 0.0002) and completed the first test round (19.3% vs 57.6%, P = 0.004) in a significant lower rate than the administrative/technical staff. One test proved false positive. No participant repeated the test one year later.

CONCLUSION: Despite the well-organized, guided and supervised provision of the service, the compliance of the Academic Hospital personnel with a FIT-based CRC screening program was suboptimal, especially among physicians.

Keywords: Colorectal cancer, Screening, Academic hospital staff, Fecal immunochemical test, Compliance

Core tip: The fecal immunochemical test (FIT) for hemoglobin represents an attractive alternative to colonoscopy for population colorectal cancer (CRC) screening programs, since it combines high diagnostic effectiveness and wide acceptance, probably in relation to its non-invasive nature. Accordingly, we assessed the compliance of the staff of an Academic Hospital with a CRC screening program by means of FIT. Despite the well-organized, guided and supervised provision of the service, our results indicated very low overall uptake rate of the test and, interestingly, significantly less compliance of physicians and nurses as compared to the rest Hospital personnel.