ESISTE LO SCREENING IDEALE?

ESISTE LO SCREENING IDEALE? Verona 17/5/2008Carlo SenoreCPO Piemonte presidente GISCoR

ALCUNI CONCETTI DI RIFERIMENTO

EFFICACIA

SOSTENIBILITA

EQUITA

QUALITA

Il programma nazionale ingleseInizio del programma pilota nel 2000

Programma di Screening annunciato nel 2004 Per uomini e donne 60-69enni in InghilterraPer uomini e donne 50-74enni in Scozia e GallesTEST: Hemoccult II con cadenza biennale

Primi pazienti invitati in Inghilterra nel luglio 200646 centri di screening attualmente attiviEstensione ai 70-74enni in Inghilterra dal 2010

Risultati del trial con sigmoidoscopia flessibile (FS) attesi con grande interesse

Il programma finlandeseInizio del programma nel 2004

TEST Hemoccult II con cadenza biennale per le persone tra 60 e 69 anni

Programma organizzato con inserimento progressivo della poplazione bersaglio su un arco di 10 anniDisegno finalizzato ad una valutazione di impatto

Il programma tedescoInizio del programma nel 2002

Non si tratta di un programma organizzato

TEST Hemoccult II con cadenza annuale per le persone tra 50 e 54 anni

Colonscopia ogni 10 anni dalleta di 55 anni, o, in alternativa FOBT (Hemoccult II biennale)

400.000 500.000 colonscopie eseguite ogni anno per una popolazione bersaglio di oltre 20.000.000 di persone

Test utilizzati per lo screening colorettale ITALIA

Dati

2006200520042003

Regione-AreaITALIANORDCENTROSUDITALIANORDCENTROSUDITALIANORDCENTROSUDITALIANORDCENTROSUD

Residenti (1)14085221668571528065794592927139938656666922278896745379761387348966214892769733448226713873489662148927697334482267

Target (2)62902914469148136074246040144846343319861965127199646114609246735166907796648545102449506095600

invitati213490617062703185601100768306195175802279368510334202615606918110048572996161050471945690

aderenti9146317344981473513278237495223421211761123129168323746129299371814611751482946350

Estensione programmi (3)44.766.848.510.032.049.834.64.48.37.124.20.26.23.722.00.0

Estensione inviti (4)15.225.511.42.45.97.88.21.92.52.46.50.12.21.67.00.0

Estensione test (5)6.511.05.30.72.73.54.20.51.21.13.40.01.10.83.40.0

Legenda

(1) popolazione in fascia d'et 50-69 residente nell'area

(2) residenti in aree coperte da programma

(3) target / residenti *100

(4) invitati / residenti * 100

(5) aderenti / residenti * 100

Dati per grafici

Estensione programmiITALIANORDCENTROSUD

20036.23.722.00.0

20048.37.124.20.2

200532.049.834.64.4

200644.766.848.510.0

Estensione invitiITALIANORDCENTROSUD

20032.21.67.00.0

20042.52.46.50.1

20055.97.88.21.9

200615.225.511.42.4

Estensione testITALIANORDCENTROSUD

20031.10.83.40.0

20041.21.13.40.0

20052.73.54.20.5

20066.511.05.30.7

G_est_programmi

6.15930138418.261022155332.047143516144.6588023007

3.699318997.058095241149.796007812966.8462236275

22.007897512124.15673279734.605178189648.4840084672

00.21560518374.399450327610.0241305817

2003

2004

2005

2006

x 100 residenti

Estensione dei programmi (pop bersaglio / pop ISTAT * 100)

G_est_inviti

2.15962978022.46532072795.935593919215.1570642733

1.58645585612.35700761577.763402661725.521129752

7.0248287476.5385363868.172775081211.3504732986

00.10836034531.87535147832.3966416187

2003

2004

2005

2006

x 100 residenti

Estensione degli inviti (invitati / pop ISTAT * 100)

G_est_test

1.0532101911.20809552672.6794027246.4935509354

0.77749883751.12681603793.513045450410.9860800229

3.41675533353.35747164084.21700938025.2501996202

00.01601867980.50967656070.7137496416

2003

2004

2005

2006

x 100 residenti

Estensione dei test (screenati / pop ISTAT * 100)

Foglio3

Estensione annuale degli invitiSoggetti invitati nel 2006

FOBTFSN programmi657Estensione (%)68.451.4

90 percentile117.097.5

10 percentile10.022.5

Adesione allinvitoAdesione superiore al 45%: 57% dei programmi

200610-90 percentilistandardAdesione FOBT (%)44.626.1 66.6>45-65%

Adesione FS (%)29.220.2 - 36.8>30-50%

Sollecito dopo un anno Torino e Novara+ 2.2%

Adesione corretta allinvito per et e sesso

Adesione corretta, per storia di screening e fascia d'et41,246,346,443,630,319,120,317,415,78,883,584,784,683,467,9010203040506070809010050-5455-5960-6465-6970+et (anni)x 100 invitatigi invitati, gi aderitogi invitati, mai aderitomai invitati

Adesione per storia di screening e copertura3 round di screening nel trial SCORE2

Proporzione di aderenti a 3 round tra gli aderenti al primo invito 68.3%

Eseguono almeno 2 test su tre inviti 88.8%

Eseguono almeno 2 test 73.4%tra coloro che hanno aderito almeno una volta

Adesione per storia di screening e coperturaAdesione media nei programmi italiani

FOBT : 45%FS: 31%

Popolazione coperta dopo 5 anni

FOBT3 test su tre inviti 31%

2 test su tre inviti40%

almeno 2 test 47%tra coloro che hanno aderito almeno una volta

FATTORI CHE INFLUENZANO LA PARTECIPAZIONE PER MODALITA DI SCREENINGSegnan et al. Journal of the National Cancer Institute 2005; 97(5)* Multivariable ORs adjusted for screening center and for all the other variables in the table

COPERTURA OTTENUTA CON LOFFERTA DEL FOBT AI NON ADERENTI ALLA FS

x 1000 screenatiMaschi. Tassi di identificazione per et 4,53,159,724,66,518,1

Grafico1

3.118.1

4.524.6

6.559.7

CANCRO

ADENOMA AVANZATO

Foglio1

VERONA

LESIONI DISTALI*NEGATIVOMUCOSA NORMALEPOLIPI IPERPLASTICIADENOMI < 1 cmADENOMI >= 1 cmCCRPOLIPO NON RECUPERATOATTESA ESITOTOTALE

TUBULARI E DISPLASIA BASSO GRADOTV - V / DISPLASIA ALTO GRADOTUBULARI E DISPLASIA BASSO GRADOTV - V / DISPLASIA ALTO GRADO

NNNNNNNNNNN

%%%%%%%%%%%

DONNE772229056551222966

79.9%2.3%9.3%5.80%0.5%0.5%1.2%0.21%0.2%0.0%

UOMINI7393214314326628541126

65.6%2.8%12.7%12.70%2.3%0.5%2.5%0.44%0.4%0.0%

TOTALE1511542331993111407602092

72.2%2.6%11.1%9.5%1.5%0.5%1.9%0.3%0.3%0.0%

TORINO



NNNNNNNNNNN

%%%%%%%%%%%

DONNE871532641051031851023

85.1%0.5%3.1%6.26%1.0%0.5%1.0%0.29%1.8%0.5%

UOMINI8269669911272992691111

74.3%0.8%5.9%8.91%1.0%2.4%2.6%0.81%2.3%0.8%

TOTALE169714981632132391244142134

79.5%0.7%4.6%7.6%1.0%1.5%1.8%0.6%2.1%0.7%

* LESIONI INDIVIDUATE DALLA SIGMOIDOSCOPIA DI SCREENING (ANCHE SE EVENTUALMENTE LOCALIZZATE A MONTE DEL GIUNTO SIGMA DISCENDENTE)

ALESSANDRIA



NNNNNNNNNNN

%%%%%%%%%%%

DONNE1920914910121229

83.8%0.0%3.9%6.11%3.9%0.4%0.0%0.44%0.9%0.4%

UOMINI16613022728311241

68.9%0.4%12.4%9.13%2.9%0.8%3.3%1.24%0.4%0.4%

TOTALE358139361638432470

76.2%0.2%8.3%7.7%3.4%0.6%1.7%0.85%0.6%0.4%


BIELLA-VERCELLI



NNNNNNNNNNN

%%%%%%%%%%%

DONNE1410111001040158

89.2%0.0%0.6%6.96%0.0%0.0%0.6%0.00%2.5%0.0%

UOMINI1401414907040179

78.2%0.6%2.2%7.82%5.0%0.0%3.9%0.00%2.2%0.0%

TOTALE2811525908080337

83.4%0.3%1.5%7.4%2.7%0.0%2.4%0.00%2.4%0.0%


COLLEGNO - RIVOLI



NNNNNNNNNNN

%%%%%%%%%%%

DONNE1942915402030229

84.7%0.9%3.9%6.55%1.7%0.0%0.9%0.00%1.3%0.0%

UOMINI18692325624230260

71.5%3.5%8.8%9.62%2.3%0.8%1.5%0.77%1.2%0.0%

TOTALE3801132401026260489

77.7%2.2%6.5%8.2%2.0%0.4%1.2%0.4%1.2%0.0%


NOVARA



NNNNNNNNNNN

%%%%%%%%%%%

DONNE808867368213262952

84.9%0.8%7.0%3.78%0.8%0.2%1.4%0.21%0.6%0.2%

UOMINI775141071052018306751087

71.3%1.3%9.8%9.66%1.8%1.7%2.8%0.55%0.6%0.5%

TOTALE15832217414128204381372039

77.6%1.1%8.5%6.9%1.4%1.0%2.1%0.4%0.6%0.3%



NNNNNNNNNNN

%%%%%%%%%%%

DONNE29783720819636133883583557

83.7%1.0%5.8%5.51%1.0%0.4%1.1%0.22%1.0%0.2%

UOMINI28326637340879551052645154004

70.7%1.6%9.3%10.19%2.0%1.4%2.6%0.65%1.1%0.4%

TOTALE5810103581604115681433480237561

76.8%1.4%7.7%8.0%1.5%0.9%1.9%0.45%1.1%0.3%

2.45%

5.97%

4.31%

FOBT 55-59 anniFOBT 60-64 anniFSFOBT 55-59 anniFOBT 60-64 anniFS

CANCRO3.14.56.5CANCRO1.72.12.2

ADENOMA AVANZATO18.124.659.7ADENOMA AVANZATO81024.5

Foglio1

00

00

00

CANCRO

ADENOMA AVANZATO

Foglio2

00

00

00

CANCRO

ADENOMA AVANZATO

Foglio3

Donne. Tassi di identificazione per et.x 1000 screenate1,78,02,110,024,52,2

Grafico2

1.78

2.110

2.224.5

CANCRO

ADENOMA AVANZATO

Foglio1

VERONA



NNNNNNNNNNN

%%%%%%%%%%%

DONNE772229056551222966

79.9%2.3%9.3%5.80%0.5%0.5%1.2%0.21%0.2%0.0%

UOMINI7393214314326628541126

65.6%2.8%12.7%12.70%2.3%0.5%2.5%0.44%0.4%0.0%

TOTALE1511542331993111407602092

72.2%2.6%11.1%9.5%1.5%0.5%1.9%0.3%0.3%0.0%

TORINO



NNNNNNNNNNN

%%%%%%%%%%%

DONNE871532641051031851023

85.1%0.5%3.1%6.26%1.0%0.5%1.0%0.29%1.8%0.5%

UOMINI8269669911272992691111

74.3%0.8%5.9%8.91%1.0%2.4%2.6%0.81%2.3%0.8%

TOTALE169714981632132391244142134

79.5%0.7%4.6%7.6%1.0%1.5%1.8%0.6%2.1%0.7%


ALESSANDRIA



NNNNNNNNNNN

%%%%%%%%%%%

DONNE1920914910121229

83.8%0.0%3.9%6.11%3.9%0.4%0.0%0.44%0.9%0.4%

UOMINI16613022728311241

68.9%0.4%12.4%9.13%2.9%0.8%3.3%1.24%0.4%0.4%

TOTALE358139361638432470

76.2%0.2%8.3%7.7%3.4%0.6%1.7%0.85%0.6%0.4%


BIELLA-VERCELLI



NNNNNNNNNNN

%%%%%%%%%%%

DONNE1410111001040158

89.2%0.0%0.6%6.96%0.0%0.0%0.6%0.00%2.5%0.0%

UOMINI1401414907040179

78.2%0.6%2.2%7.82%5.0%0.0%3.9%0.00%2.2%0.0%

TOTALE2811525908080337

83.4%0.3%1.5%7.4%2.7%0.0%2.4%0.00%2.4%0.0%


COLLEGNO - RIVOLI



NNNNNNNNNNN

%%%%%%%%%%%

DONNE1942915402030229

84.7%0.9%3.9%6.55%1.7%0.0%0.9%0.00%1.3%0.0%

UOMINI18692325624230260

71.5%3.5%8.8%9.62%2.3%0.8%1.5%0.77%1.2%0.0%

TOTALE3801132401026260489

77.7%2.2%6.5%8.2%2.0%0.4%1.2%0.4%1.2%0.0%


NOVARA



NNNNNNNNNNN

%%%%%%%%%%%

DONNE808867368213262952

84.9%0.8%7.0%3.78%0.8%0.2%1.4%0.21%0.6%0.2%

UOMINI775141071052018306751087

71.3%1.3%9.8%9.66%1.8%1.7%2.8%0.55%0.6%0.5%

TOTALE15832217414128204381372039

77.6%1.1%8.5%6.9%1.4%1.0%2.1%0.4%0.6%0.3%



NNNNNNNNNNN

%%%%%%%%%%%

DONNE29783720819636133883583557

83.7%1.0%5.8%5.51%1.0%0.4%1.1%0.22%1.0%0.2%

UOMINI28326637340879551052645154004

70.7%1.6%9.3%10.19%2.0%1.4%2.6%0.65%1.1%0.4%

TOTALE5810103581604115681433480237561

76.8%1.4%7.7%8.0%1.5%0.9%1.9%0.45%1.1%0.3%

2.45%

5.97%

4.31%

FOBT 55-59 anniFOBT 60-64 anniFSFOBT 55-59 anniFOBT 60-64 anniFS

CANCRO3.14.56.5CANCRO1.72.12.2

ADENOMA AVANZATO18.124.659.7ADENOMA AVANZATO81024.5

Foglio1

00

00

00

CANCRO

ADENOMA AVANZATO

Foglio2

00

00

00

CANCRO

ADENOMA AVANZATO

Foglio3

Distribuzione per stadio alla diagnosi * adenomi cancerizzati trattati con sola resezione endoscopica** Modificato da Mangone e De Lisi

StadioScreening 2006 (n=1533)Screening 2005 (n=819)Reggio Emilia - Parma 1994-2003 (n=3353)**I41%43%20%I*15%16%-II20%18%29%III-IV25%22%51%

RISPONDENZA ALLINVITO PER CENTRO

Foglio1

FIRENZETABLE 1RANDOMIZATIONFOBTFSCT

INVITATIADERENTIINVITATIADERENTIINVITATIADERENTI

INVITATIADERENTIRANDOMIZEDINVITEDRANDOMIZEDINVITEDRANDOMIZEDINVITEDRANDOMIZEDINVITEDRANDOMIZEDINVITEDRANDOMIZEDINVITEDBIELLA10322601007241996167

N%NNNNNN25.2%23.9%16.8%

FOBT (posta)2218036.2%%%%%%%FIRENZE971324929297945264

FOBT (non posta)63323937.8%FOBT (mail)182182221221434434185185195819582980298033.4%32.0%27.9%

SCELTA373369.7%FS40.9%100.0%MILANO101423610482581051211

5213.9%FOBT14004200FOBT (GP/centre)4574576336331130824480480290429045604529823.3%24.6%20.1%

FS "once-only"3967719.4%380094.5%RIMINI803262817279804215

FS +FOBT118225921.9%8000Choice- FS or FOBT2792793733736820282282178917893405272332.6%34.1%26.7%

2805TORINO126232912143441204257

FS "once-only"280280396396680680280280183218323468346826.1%28.3%21.3%

100.0%VERONA99956310035251021483

RIMINIFS +FOBT83883811821182205508498495444544410368831356.4%52.3%47.3%

80.2%TOTALE608119746018194460211597

LOTTO 1TOTAL203620362805280549811938207620761392713927258252278232.5%32.3%26.5%

INVITATIADERENTI

N%EXCLUDED2012203522805531606

FOBT (posta)2349239.3%

FOBT (non posta)61120132.9%1121567168827513

SCELTA282279.6%FS27.6%

7125.2%FOBT29119

FS "once-only"3578924.9%

FS +FOBT107823321.6%

2562

TOTAL

BIELLA

TABLE 2EXCLUSIONS BY GPs

LOTTO 1

INVITATIADERENTIBIELLAFIRENZEMILANORIMINITORINOTOTAL

N%NNNNNN

FOBT (posta)2514819.1%%%%%%%

FOBT (non posta)63311718.5%Previous CRC14411125192

SCELTA3844210.9%FS47.7%7.0%1.8%3.1%4.3%9.2%5.7%

4612.0%FOBTPrevious polyps/IBD1014259950198

FS "once-only"3856516.9%5.0%6.4%7.1%35.4%9.0%12.3%

FS +FOBT115416314.1%FS/TC within 2 years2628394386222

280712.9%12.7%11.1%15.4%15.6%13.8%

FOBT within 2 years1558536346235

7.5%26.4%15.1%22.5%8.3%14.6%

Severe disease18396025160302

MILANO9.0%17.7%17.0%8.9%28.9%18.8%

Severe psychiatric symptoms13304823118232

LOTTO 16.5%13.6%13.6%8.2%21.3%14.4%

INVITATIADERENTIDISTAL FINDING BY SCREENING CENTREEmigrated105471161542325

N%NEGATIVENORMAL MUCOSAHYPERPLASTIC POLYPSLR < 10 mm ADENOMAHR < 10 mm ADENOMAADVANCED ADENOMACRCMISSED POLYPTOTAL52.2%21.4%33.0%5.4%7.6%20.2%

FOBT (posta)4345512.7%TOTAL2012203522805531606

FOBT (non posta)113015914.1%BIELLA212371638314266

SCELTA67920.3%FS4.0%79.7%1.1%2.6%6.0%1.1%3.0%1.1%5.3%

487.1%FOBTFIRENZE3161102311731372

FS "once-only"685334.8%84.9%0.3%2.7%6.2%3.0%1.9%0.8%0.3%

FS +FOBT2053110.5%MILANO40102010246

498187.0%2.2%0.0%4.3%0.0%2.2%0.0%4.3%

RIMINI289216233814346

83.5%0.6%4.6%6.6%0.9%2.3%0.3%1.2%

TORINO136115691098642321660

82.0%0.9%4.2%6.6%0.5%3.9%0.1%1.9%

TOTAL22182210217325889532690

82.5%0.8%3.8%6.4%0.9%3.3%0.3%2.0%MEDICI

COMPLETION RATE OF FS BY SCREENING CENTRE AND REASON FOR STOPPING0

TORINO

FSINCOMPLETE FSINCOMPLETE FSINCOMPLETE FSINCOMPLETE FSINCOMPLETE FSTOTAL

COMPLETEDPREPARATIONPATIENT'S PAINADHESIONSOTHER REASONSREASON MISSING

INVITATIADERENTIBIELLA21510121865266

N%80.8%3.8%4.5%6.8%2.3%1.9%

FOBT (posta)115831327.0%FIRENZE2975310912372

FOBT (non posta)290474625.7%79.8%14.2%2.7%2.4%0.3%0.5%

SCELTA178921512.0%FS52.3%MILANO396001046

19611.0%FOBT84.8%13.0%0.0%0.0%2.2%0.0%

FS "once-only"183243823.9%RIMINI30912110113346

FS +FOBT5444125423.0%89.3%3.5%3.2%0.0%0.3%3.8%

13127TORINO1466963058831661

88.3%5.8%1.8%3.5%0.5%0.2%

40621255TOTAL2287171638516232645

86.5%6.5%2.4%3.2%0.6%0.9%

COMPLETION RATE OF COLONOSCOPY

INDICATEDPERFORMEDCOMPLETEDLIMITED TO SPLENIC FLEXURE

NNNN

%%%

INVITATIADERENTIBIELLA2520104

N%80.0%50.0%20.0%

FOBT (posta)56816529.0%FIRENZE3635313

FOBT (non posta)145735324.2%97.2%88.6%8.6%

SCELTA8839010.2%MILANO11311

627.0%27.3%33.3%33.3%

FS "once-only"91020022.0%RIMINI3028261

FS +FOBT274456720.7%93.3%92.9%3.6%

6562TORINO18316113216

88.0%82.0%9.9%

TOTAL28524720025

86.7%81.0%10.1%

COMPLIANCE BY SCREENING STRATEGY

BIELLAFIRENZEMILANORIMINITORINOTOTAL

INVITEDCOMPLIERSINVITEDCOMPLIERSINVITEDCOMPLIERSINVITEDCOMPLIERSINVITEDCOMPLIERSINVITEDCOMPLIERS

NNNNNNNNNNNN

%%%%%%

FOBT (mail)2514822180434552349211583132298588

19.1%36.2%12.7%39.3%27.0%25.6%

FOBT (GP/centre)6331176332391130159611201290474659111462

18.5%37.8%14.1%32.9%25.7%24.7%

Choice- FS384423733667922822717892153507322

10.9%9.7%0.3%9.6%12.0%9.2%

FOBT46524871196413

12.0%13.9%7.1%25.2%11.0%11.8%

FS "once-only"3856539677685333578918324383655702

16.9%19.4%4.8%24.9%23.9%19.2%

FS +FOBT11541631182259205311107823354441254109111920

14.1%21.9%0.5%21.6%23.0%17.6%

2807481280574349813082562713131273162262825407

COMPLIANCE BY SCREENING STRATEGY

FOBT RESULTS

TORINO

PerformedPositiveTC performedAdvanced Lesions

11545334112CRC

4.6%9AAd

VPP32.4%

FIRENZE


371131351CRC

3.5%4AAd

VPP38.5%

RIMINI


349181691CRC

5.2%(4 prox; 5 dist)8AAd

VPP56.3%

BIELLA


1879721CRC(prox)

4.8%(1 prox; 1 dist)1AAd

VPP28.6%

MILANO


25611310CRC

4.3%1AAd

VPP33.3%

ALL CENTRES


231710473285CRC

4.5%23AAd

VPP38.4%

0.38%

Foglio2

Foglio3

TASSO DI IDENTIFICAZIONE lesioni prossimali avanzate

CT (n=1597) 2.8%(39 adenomi; 5 CCR)72.7% con reperto distale negativo o con polipi a basso rischio

Studio multicentrico per il confronto di diverse

strategie di screening dei tumori colorettali.

CPO Piemonte Fondo Edo Tempia ASL 12 Biella

ASL Citt di Milano CSPO Firenze AUSL Rimini

ASL 20 Verona Lega Italiana per la Lotta Contro i Tumori

Odds ratio for advanced adenomas by screening arm, gender and ageSegnan et al. Gastroeneterology 2007

SINTESIPOPOLAZIONE BERSAGLIO:10.000 personeFOBT (n=3600) 98 adenomi avanzati 12 CCR

FS(n= 3190) 162 adenomi avanzati 14 CCR

CT(n=2650) 167 adenomi avanzati 21 CCR

COSTI FOBT (25 ) 202.500

FS (110 ) 350.900

CT (250 ) 662.500

Studio multicentrico italiano per la valutazione di diverse strategie di

screening dei tumori del colon-retto

CPO Piemonte

Fondo Edo Tempia ASL 12 Biella

ASL Citt di Milano

CSPO Firenze

ASL 13 Rimini

Associazione Italiana per la Ricerca sul Cancro

_997537612.doc

Progetto dimostrativo di

screening dei tumori del colon-retto

Regione Piemonte - Assessorato alla Sanita'

CPO Piemonte

ASL 1-4

AO S. Giovanni Battista-Molinette,

Ospedale Mauriziano "Umberto I" - IRCC

Medici di Medicina Generale

Associazione Italiana per la Ricerca sul Cancro

Standard accettabile >90% entro 30 gg, desiderabile >95% entro 30 gg

FATTIBILITA E COSTIFOBT SCREENING

120,000 PERSONE DI ETA 50 - 69

PARTECIPAZIONE 50%

POSITIVITA 5%

FS SCREENING

12,000 PERSONE DI 58 ANNI

PARTECIPAZIONE 50%

INVII IN TC 7.5%

CARICO DI LAVORO ENDOSCOPICO3000 CT (9000 FS)CARICO DI LAVORO ENDOSCOPICO6000 FS + 450 CTCOSTO PER PERSONA ESAMINATA: 1 FS 4 FOBT

PIEMONTE

Adesione 25%

N. test/

anno

Costo()/

anno

Morti evitate

Casi prevenuti

FOBT 50-69 aa

ogni 2 anni

137819

+

CT: 3673

3 445 486

329

+

186

372

FS once only

58 aa

14617

+

CT: 1023

1 534 785

58

+

575

1150

+

FOBT 59-69

39440

(73274-6414)

+

CT: 974

(1815-158)

985 994

(1831841-160360)

158

+

78

157

REQUISITI STRUTTURALII programmi di screening in Germania, Polonia, Ontario, UK richiedono ai centri e agli operatori che svolgono attivit per il programma di garantire un minimo di attivit ogni anno

Ad esempio in Germania ogni operatore deve effettuare almeno 200 colonscopie con 10 polipectomie ogni anno

A Torino solo 3 dei 26 operatori che hanno eseguito pi di 10 CT/anno negli ultimi due anni ne hanno effettuate pi di 50

Grafico2

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0.07927438940.10027622170.0614547184

0.07927438940.10027308560.0614555185

0.07927438940.10026995380.0614562404

mean

UCL

LCL

unit

DR adenomi - donne

Foglio1

distribution of examinersdistribution of examiners

WOMENN33 percentilemedian67 percentileMENN33 percentilemedian67 percentile

%%

Pain91311.0%14.0%16.2%Pain3785.0%5.3%7.3%

13.7%5.3%

Duration < 5 minutes353131.3%40.5%50.2%Duration < 5 minutes367128.6%37.6%55.5%

53.0%51.7%

% incomplete FS90511.1%16.3%17.7%% incomplete FS5927.1%8.4%11.2%

13.6%8.3%

DR polyps92011.4%12.9%14.9%DR polyps170220.6%23.5%25.9%

13.8%24.0%

DR adenomas5296.2%7.5%9.0%DR adenomas96211.8%12.4%15.2%

7.9%13.6%

DR advanced adenomas + CRC2532.8%3.3%3.8%DR advanced adenomas + CRC4465.3%5.9%6.8%

3.8%6.3%

Number of tests6668Number of tests7095

dati operatori

Z-a1.963.84

Z-b0.84

Cases =670336.842turco4.9%1ferraris2.3%musso1.0%

16722.4572.5%5.3%10.5%10.6%23.2%16.0%secreto5.8%2sprujevnik2.8%formento1.7%

EXACT METHOD1.9%5.0%11.8%4.5%17.0%9.1%martinoglio6.1%3formento3.0%martinoglio2.0%

p24.9%95% CI3.9%9.4%19.9%14.1%36.0%23.4%formento6.4%4reggio3.4%tabone2.1%

q0.750721.7%28.4%5.2%9.4%16.3%23.2%43.4%32.6%sprujevnik7.3%5martinoglio3.4%ferraris2.3%

2.8%5.1%8.9%4.5%11.6%7.3%repici7.4%6turco3.8%turco2.5%

Tabella 1 di OPERATOR per dolorscarti1.4%2.8%5.5%6.6%13.0%9.3%bruno7.8%7musso3.9%sprujevnik2.8%

ControllodiSESSO=FFM0.3%0.8%1.9%2.4%5.3%3.6%cosimato8.6%8cosimato4.1%reggio2.8%

OPERATORdolorTotale3334071.0%1.8%3.2%6.8%11.6%8.9%ferraris9.7%9pennazio4.1%repici2.9%

.12FM2.0%5.3%12.4%6.5%22.2%12.5%caronna9.7%10secreto4.3%garripoli2.9%

Giovanni Bosco03474117.1%3.4%13.6%17.7%22.7%33.6%45.2%39.2%tabone9.8%11di placido4.5%bruno3.1%

Maria Vittoria42183324.2%2.9%1.8%3.3%5.7%10.7%18.3%14.1%mondardini10.0%12bruno4.7%secreto3.2%

Martini474169417.0%10.2%1.1%2.7%6.1%4.7%14.8%8.6%garripoli10.5%13garripoli4.7%caronna3.2%

Mauriziano06060.0%12.5%6.2%8.8%12.3%15.1%22.8%18.6%spandre10.6%14repici4.8%coppola3.3%

Molinette135175332.1%7.8%3.0%6.0%11.5%13.3%26.7%19.2%reggio10.6%15caronna5.1%mondardini3.5%

S Giovanni Bos157127017.1%4.4%4.3%6.6%10.0%9.3%17.3%12.8%pennazio11.1%16mondardini5.2%cosimato3.6%

SGAS4302363335.6%8.3%7.7%13.3%21.7%18.8%37.0%27.0%saracco11.7%17santucci5.2%pennazio3.6%

1411723144arrigoni23.2%10.6%16.0%10.6%23.2%84.0%5.3%5.4%8.9%14.1%9.5%19.7%13.8%cavallero12.1%18tabone5.4%di placido3.7%

2783999bertone17.0%4.5%9.1%4.5%17.0%90.9%5.0%6.4%12.0%20.8%18.8%38.4%27.6%musso12.2%19bertone5.5%fracchia3.8%

31481564bruno36.0%14.1%23.4%14.1%36.0%76.6%9.4%5.6%8.5%12.6%16.2%26.9%21.1%santucci12.3%20cavallero5.8%saracco4.0%

41592989caronna43.4%23.2%32.6%23.2%43.4%67.4%9.4%1.0%4.0%12.0%9.3%26.6%16.3%arrigoni12.5%21saracco6.6%arrigoni4.1%

52020718245cavallero11.6%4.5%7.3%4.5%11.6%92.7%5.1%3.2%5.0%7.6%12.6%20.4%16.1%coppola13.5%22arrigoni6.8%santucci4.5%

6231933354coppola13.0%6.6%9.3%6.6%13.0%90.7%2.8%5.1%7.5%10.9%11.9%20.0%15.5%bertone13.6%23fracchia6.9%bertone4.5%

7667125702cosimato5.3%2.4%3.6%2.4%5.3%96.4%0.8%2.7%4.6%7.4%5.3%12.1%8.1%fracchia15.1%24spandre7.1%galatola5.0%

8752652585di placido11.6%6.8%8.9%6.8%11.6%91.1%1.8%1.4%5.4%15.8%4.7%23.7%11.3%galatola15.5%25coppola7.3%cavallero5.6%

92681080ferraris22.2%6.5%12.5%6.5%22.2%87.5%5.3%1.1%2.1%3.9%8.2%14.0%10.8%di placido19.9%26galatola7.8%spandre6.1%

102173113288formento45.2%33.6%39.2%33.6%45.2%60.8%17.7%3.3%5.1%7.7%8.3%14.1%10.9%ferraris9.7%ferraris2.3%100.0%ferraris2.3%

11329048341fracchia18.3%10.7%14.1%10.7%18.3%85.9%3.3%4.9%5.4%6.0%13.1%14.8%13.9%tabone9.8%tabone5.4%38.5%tabone2.1%

12212612140galatola14.8%4.7%8.6%4.7%14.8%91.4%2.7%coppola13.5%coppola7.3%44.9%coppola3.3%

132031677413garripoli22.8%15.1%18.6%15.1%22.8%81.4%8.8%fracchia15.1%fracchia6.9%54.9%fracchia3.8%

14411428146martinoglio26.7%13.3%19.2%13.3%26.7%80.8%6.0%galatola15.5%galatola7.8%64.3%galatola5.0%

151823537290mondardini17.3%9.3%12.8%9.3%17.3%87.2%6.4%

1627127100musso37.0%18.8%27.0%18.8%37.0%73.0%13.3%

171615227195pennazio19.7%9.5%13.8%9.5%19.7%86.2%8.9%musso12.2%17musso3.9%625.0%musso1.0%18.0%

180632487reggio38.4%18.8%27.6%18.8%38.4%72.4%12.9%di placido19.9%21di placido4.5%1082.5%di placido3.7%1518.8%

19718451242repici26.9%16.2%21.1%16.2%26.9%78.9%8.6%reggio10.6%13reggio3.4%383.3%reggio2.8%626.3%

200671380santucci26.6%9.3%16.3%9.3%26.6%83.8%4.0%formento6.4%4formento3.0%258.8%formento1.7%227.0%

21729558360saracco20.4%12.6%16.1%12.6%20.4%83.9%4.9%garripoli10.5%11garripoli4.7%1262.2%garripoli2.9%827.7%

22427952335secreto20.0%11.9%15.5%11.9%20.0%84.5%7.5%arrigoni12.5%19arrigoni6.8%2060.0%arrigoni4.1%1732.4%

231324823284spandre12.1%5.3%8.1%5.3%12.1%91.9%4.6%pennazio11.1%14pennazio4.1%887.5%pennazio3.6%1432.6%

24443653sprujevnik23.7%4.7%11.3%4.7%23.7%88.7%5.4%martinoglio6.1%3martinoglio3.4%460.0%martinoglio2.0%333.3%

25642552483tabone14.0%8.2%10.8%8.2%14.0%89.2%2.1%caronna9.7%9caronna5.1%1463.6%caronna3.2%1133.3%

261640251469913turco14.1%8.3%10.9%8.3%14.1%89.1%5.1%bertone13.6%20bertone5.5%1781.8%bertone4.5%1933.3%

Totale188583897570016668Totale14.8%13.1%13.9%13.1%14.8%86.1%5.4%saracco11.7%15saracco6.6%1959.6%saracco4.0%1633.7%

mondardini10.0%10mondardini5.2%1568.8%mondardini3.5%1235.5%

Tabella 2 di OPERATOR per dolor14.0%santucci12.3%18santucci5.2%1687.5%santucci4.5%1836.8%

ControllodiSESSO=M11.0%sprujevnik7.3%5sprujevnik2.8%1100.0%sprujevnik2.8%537.5%

OPERATORdolorTotale16.2%repici7.4%6repici4.8%1360.0%repici2.9%738.5%

.12bruno7.8%7bruno4.7%1166.7%bruno3.1%940.0%

Giovanni Bosco0572593.4%cosimato8.6%8cosimato4.1%787.9%cosimato3.6%1341.8%

Maria Vittoria5281342.9%cavallero12.1%16cavallero5.8%1896.4%cavallero5.6%2046.6%

Martini12941211810.2%turco4.9%1turco3.8%565.7%turco2.5%451.1%

Mauriziano161812.5%secreto5.8%2secreto4.3%973.3%secreto3.2%1055.0%

Molinette3444517.8%spandre10.6%12spandre7.1%2186.7%spandre6.1%2158.2%

S Giovanni Bos0854894.5%

SGAS8364484078.3%

111133815210.5%2.5%5.3%2.5%10.5%94.7%

21580510011.8%1.9%5.0%1.9%11.8%95.0%

325666419.9%3.9%9.4%3.9%19.9%90.6%

421131212716.3%5.2%9.4%5.2%16.3%90.6%

515209122368.9%2.8%5.1%2.8%8.9%94.9%

6430593185.5%1.4%2.8%1.4%5.5%97.2%

71069467101.9%0.3%0.8%0.3%1.9%99.2%

85653126703.2%1.0%1.8%1.0%3.2%98.2%

918959512.4%2.0%5.3%2.0%12.4%94.7%

1042335128822.7%13.6%17.7%13.6%22.7%82.3%

117376133965.7%1.8%3.3%1.8%5.7%96.7%

12221362216.1%1.1%2.7%1.1%6.1%97.3%

13293123337412.3%6.2%8.8%6.2%12.3%91.2%

143137914911.5%3.0%6.0%3.0%11.5%94.0%

15242852233110.0%4.3%6.6%4.3%10.0%93.4%

162891410521.7%7.7%13.3%7.7%21.7%86.7%

17141601719114.1%5.4%8.9%5.4%14.1%91.1%

18081119220.8%6.4%12.0%6.4%20.8%88.0%

1962522428212.6%5.6%8.5%5.6%12.6%91.5%

2027037512.0%1.0%4.0%1.0%12.0%96.0%

219394214247.6%3.2%5.0%3.2%7.6%95.0%

22123212736010.9%5.1%7.5%5.1%10.9%92.5%

2322313163517.4%2.7%4.6%2.7%7.4%95.4%

2464735615.8%1.4%5.4%1.4%15.8%94.6%

253465104783783.9%1.1%2.1%1.1%3.9%97.9%

26194082345070957.7%3.3%5.1%3.3%7.7%94.9%

Totale258683840675026.0%4.9%5.4%4.9%6.0%94.6%

Tabella 1 di OPERATOR per durata25.3%

ControllodiSESSO=F5.0%

OPERATORdurata2Totale7.3%

.1231-5 minuti6-10 minuti> 10 minuti

Giovanni Bosco0828541119.5%68.3%12.2%

Maria Vittoria01712433251.5%36.4%12.1%

Martini638321894340.4%34.0%19.1%

Mauriziano01416416.7%66.7%16.7%

Molinette12127453539.6%50.9%7.5%

S Giovanni Bos23628470651.4%40.0%5.7%

SGAS9914436725.0%38.9%11.1%

12102346144870.8%23.6%4.2%

202565999925.3%65.7%9.1%

30122527641018.8%39.1%42.2%

41186010891120.2%67.4%11.2%

569769282451231.0%37.6%3.3%

6129647103541383.6%13.3%2.8%

7126483667021492.3%5.1%0.9%

84448111225851576.6%19.0%3.8%

9157211801671.3%26.3%1.3%

101491111272881717.0%38.5%44.1%

111684224173411824.6%65.7%5.0%

1234574181401932.1%52.9%12.9%

133238136364132057.6%32.9%8.7%

141706961462147.9%47.3%4.1%

1532087272902271.7%24.8%2.4%

1624245111002342.0%45.0%11.0%

17127694131952439.0%48.2%6.7%

18423528872526.4%59.8%9.2%

191589121172422636.8%50.0%7.0%

20115559802718.8%68.8%11.3%

211121206323602833.6%57.2%8.9%

2214151147233352945.1%43.9%6.9%

23557203192843020.1%71.5%6.7%

241271510533150.9%28.3%18.9%

2502262253248335313246.8%46.6%6.6%

263328112264693369.9%23.9%5.5%

Totale1933661259755070013452.3%37.1%7.9%

Tabella 2 di OPERATOR per durata240.5%

ControllodiSESSO=M31.3%

OPERATORdurata2Totale50.2%

.1231-5 minuti6-10 minuti> 10 minuti

Giovanni Bosco01634959127.1%57.6%15.3%

Maria Vittoria0248234270.6%23.5%5.9%

Martini1574713118348.3%39.8%11.0%

Mauriziano1061840.0%75.0%12.5%

Molinette21928251537.3%54.9%3.9%

S Giovanni Bos251261089657.3%29.2%11.2%

SGAS91220748725.0%41.7%14.6%

16102359152867.1%23.0%5.9%

2622648100922.0%64.0%8.0%

31153216641023.4%50.0%25.0%

411985221271115.0%66.9%17.3%

5506699212361228.0%41.9%8.9%

6224360133181376.4%18.9%4.1%

7136404897101490.1%6.8%1.3%

86544110106701581.2%16.4%1.5%

9167216951670.5%22.1%6.3%

101321261292881711.1%43.8%44.8%

1114107255203961827.0%64.4%5.1%

12183111262211937.6%50.2%11.8%

137226113283742060.4%30.2%7.5%

1408451141492156.4%34.2%9.4%

15222090193312266.5%27.2%5.7%

1614445151052341.9%42.9%14.3%

1797289211912437.7%46.6%11.0%

18326558922528.3%59.8%8.7%

191683151322822629.4%53.5%11.3%

200234012752730.7%53.3%16.0%

215158223384242837.3%52.6%9.0%

2212191141163602953.1%39.2%4.4%

231150262283513014.2%74.6%8.0%

245152016563126.8%35.7%28.6%

2532242104147836713246.9%43.9%8.6%

263315107254503370.0%23.8%5.6%

Totale1943850281264675023451.3%37.5%8.6%

Tabella 1 di OPERATOR per COMPLETA37.6%


OPERATORCOMPLETATotale55.5%

.12FM

Giovanni Bosco036541112.2%6.8%

Maria Vittoria027633218.2%2.9%

Martini08869436.4%1.7%

Mauriziano0516416.7%12.5%

Molinette0401353524.5%19.6%

S Giovanni Bos063770610.0%6.7%

SGAS030636716.7%14.6%

10120241445318.9%816.7%11.2%24.0%83.3%10.5%

208217996418.8%917.2%10.6%26.4%82.8%19.0%

305212648021.3%1018.8%10.5%30.8%81.3%6.3%

407019898011.3%1121.3%13.7%31.6%78.7%11.8%

50201442458623.3%1218.0%13.5%23.5%82.0%12.3%

60330243548921.3%136.8%4.5%10.1%93.2%4.4%

70624767009917.2%1410.9%8.7%13.5%89.1%7.3%

8048110358410016.0%1517.6%14.7%21.0%82.4%10.3%

9063178014013.6%1621.3%13.2%32.1%78.8%11.7%

1002711728814416.7%175.9%3.6%9.5%94.1%2.8%

1102548834214615.8%1825.7%21.2%30.8%74.3%11.4%

1201211914019625.0%1913.6%8.6%20.6%86.4%14.8%

130345694142438.6%2016.7%13.3%20.7%83.3%7.2%

1401232314624518.0%2115.8%10.4%22.9%84.2%4.7%

1502712029128410.2%226.9%4.4%10.6%93.1%6.4%

16084161002885.9%2316.0%9.7%25.0%84.0%8.6%

170147491962916.9%2425.0%19.2%31.8%75.0%18.8%

1806620863359.3%2523.3%15.1%33.8%76.7%11.8%

1902222124334225.7%268.6%5.6%13.1%91.4%7.1%

200719803546.8%2711.3%5.6%20.8%88.8%12.0%

2103204036036011.1%2811.1%8.1%14.9%88.9%9.9%

2203043133541416.7%299.3%6.5%13.0%90.7%6.9%

230255292844694.7%3010.2%7.1%14.5%89.8%4.6%

24043105348417.8%3118.9%9.9%32.4%81.1%7.1%

2503988648490558417.6%3217.8%14.5%21.5%82.2%8.2%

2604472246970010.9%334.7%3.0%7.1%95.3%2.4%

Totale060549497003700313.6%TOTALE13.6%12.8%14.4%86.4%8.3%

Tabella 2 di OPERATOR per COMPLETA16.3%


OPERATORCOMPLETATotale17.7%

.12M

Giovanni Bosco05545916.8%

Maria Vittoria03313422.9%

Martini1115211831.7%

Mauriziano0718412.5%

Molinette0411051519.6%


SGAS041748714.6%

1013616152567.1%810.5%6.3%16.8%89.5%

208119100646.3%919.0%12.1%28.3%81.0%

30604647512.0%106.3%2.0%16.0%93.8%

40112151279311.8%1111.8%7.0%19.0%88.2%

50207292369411.7%1212.3%8.5%17.3%87.7%

603041431810019.0%134.4%2.5%7.4%95.6%

72655527091058.6%147.3%5.6%9.6%92.7%

806016967012711.8%1510.3%8.2%12.9%89.7%

908311941504.7%1611.7%6.3%20.4%88.3%

100280828815210.5%172.8%1.3%5.6%97.2%

1103504539519118.8%1811.4%8.5%15.0%88.6%

1201903322322314.8%1914.8%10.5%20.3%85.2%

1303472737423612.3%207.2%4.9%10.5%92.8%

14014371502807.1%214.7%2.1%9.7%95.3%

150309213302882.8%226.4%4.1%9.7%93.6%

1609691053184.4%238.6%4.2%16.1%91.4%

170155361913306.4%2418.8%13.7%25.3%81.2%

1808211933514.6%2511.8%6.3%20.6%88.2%

190260202803606.9%267.1%4.5%11.0%92.9%

200669753747.2%2712.0%6.0%22.0%88.0%

2103834242539511.4%289.9%7.3%13.2%90.1%

220335253604259.9%296.9%4.6%10.2%93.1%

230335163514502.4%304.6%2.7%7.4%95.4%

240524564788.2%317.1%2.3%18.1%92.9%

2504393947859267010.3%328.2%5.9%11.1%91.8%

260439114507097.3%332.4%1.3%4.5%97.6%

Totale36876623750275028.3%348.3%7.7%9.0%91.7%

Tabella 1 di OPERATOR per vis_compl8.4%


OPERATORvis_complTotale11.2%

.1234FS completa - ottimaleFS completa - non ottimaleFS incompleta - doloreFS incompleta - feci

Giovanni Bosco0279414165.9%22.0%9.8%2.4%1

Maria Vittoria01215423336.4%45.5%12.1%6.1%2

Martini05528389458.5%29.8%3.2%8.5%3

Mauriziano05001683.3%0.0%0.0%16.7%4

Molinette02317765343.4%32.1%13.2%11.3%5

S Giovanni Bos04518437064.3%25.7%5.7%4.3%6

SGAS0228243661.1%22.2%5.6%11.1%7

arrigoni08530121714459.0%20.8%8.3%11.8%8

bertone057251259957.6%25.3%12.1%5.1%9

bruno015361036423.4%56.3%15.6%4.7%10

caronna059101918966.3%11.2%21.3%1.1%11

cavallero016733252024568.2%13.5%10.2%8.2%12

coppola022810221335464.4%28.8%5.9%0.8%13

cosimato054677631670277.8%11.0%9.0%2.3%14

di placido0213267762958536.4%45.6%13.0%5.0%15

ferraris039241168048.8%30.0%13.8%7.5%16

formento02234711728877.4%16.3%3.8%2.4%17

fracchia0136116751434139.9%34.0%22.0%4.1%18

galatola0715016314050.7%35.7%11.4%2.1%19

garripoli0180159472741343.6%38.5%11.4%6.5%20

martinoglio0804318514654.8%29.5%12.3%3.4%21

mondardini016410416629056.6%35.9%5.5%2.1%22

musso0374381210037.0%43.0%8.0%12.0%23

pennazio010938262219555.9%19.5%13.3%11.3%24

reggio034335158739.1%37.9%5.7%17.2%25

repici01368512924256.2%35.1%5.0%3.7%26

santucci05417638067.5%21.3%7.5%3.8%27

saracco095225231736026.4%62.5%6.4%4.7%28

secreto013417028333540.0%50.7%8.4%0.9%29

spandre02243024628478.9%10.6%8.5%2.1%30

sprujevnik02122735339.6%41.5%13.2%5.7%31

tabone0199199661948341.2%41.2%13.7%3.9%32

turco027517019546958.6%36.2%4.1%1.1%33

Totale037702250680301700153.8%32.1%9.7%4.3%34

Tabella 2 di OPERATOR per vis_compl

ControllodiSESSO=M

OPERATORvis_complTotale

.1234FS completa - ottimaleFS completa - non ottimaleFS incompleta - doloreFS incompleta - feci

Giovanni Bosco03223315954.2%39.0%5.1%1.7%1

Maria Vittoria01814113452.9%41.2%2.9%2.9%2

Martini173381511861.9%32.2%0.8%4.2%3

Mauriziano03410837.5%50.0%12.5%0.0%4

Molinette020210105139.2%41.2%0.0%19.6%5

S Giovanni Bos04934338955.1%38.2%3.4%3.4%6

SGAS02615344854.2%31.3%6.3%8.3%7

arrigoni08645101115256.6%29.6%6.6%7.2%8

bertone0552611810055.0%26.0%11.0%8.0%9

bruno01247146418.8%73.4%1.6%6.3%10

caronna0753710512759.1%29.1%7.9%3.9%11

cavallero01664072323670.3%16.9%3.0%9.7%12

coppola01841208631857.9%37.7%2.5%1.9%13

cosimato2523126243571073.7%17.7%3.4%4.9%14

di placido0268328195567040.0%49.0%2.8%8.2%15

ferraris05133389553.7%34.7%3.2%8.4%16

formento0210681928872.9%23.6%0.3%3.1%17

fracchia0204142232739651.5%35.9%5.8%6.8%18

galatola010188181422145.7%39.8%8.1%6.3%19

garripoli0160182122037442.8%48.7%3.2%5.3%20

martinoglio098445214965.8%29.5%3.4%1.3%21

mondardini016314613933149.2%44.1%3.9%2.7%22

musso037565710535.2%53.3%4.8%6.7%23

pennazio09856162119151.3%29.3%8.4%11.0%24

reggio04735199251.1%38.0%1.1%9.8%25

repici015410714728254.6%37.9%5.0%2.5%26

santucci05214187569.3%18.7%1.3%10.7%27

saracco095285103442422.4%67.2%2.4%8.0%28

secreto0131201141436036.4%55.8%3.9%3.9%29

spandre02795512535179.5%15.7%3.4%1.4%30

sprujevnik02624245646.4%42.9%3.6%7.1%31

tabone0226211251647847.3%44.1%5.2%3.3%32

turco02481906645055.1%42.2%1.3%1.3%33

Totale339702855283391750252.9%38.1%3.8%5.2%34

Tabella 1 di OPERATOR per INDICA_CT

ControllodiSESSO=F

OPERATORINDICA_CTTotale

012CT appropriataCT inappropriata

Giovanni Bosco40104112.4%0.0%0.0%

Maria Vittoria32103323.0%0.0%0.0%

Martini89329433.2%2.1%40.0%

Mauriziano501640.0%16.7%100.0%

Molinette51115351.9%1.9%50.0%

S Giovanni Bos67307064.3%0.0%0.0%

SGAS32313678.3%2.8%25.0%

11297814453.3%84.9%5.6%2.6%11.0%94.4%5333.3%2450215333.3%

2980199100.0%90.0%1.0%0.1%6.3%99.0%6433.3%358426433.3%

358426433.3%106.3%3.1%0.5%11.8%96.9%8050.0%2078118050.0%

483518916.7%115.6%1.1%0.1%7.0%98.9%8066.7%1877128066.7%

522815224511.8%126.1%0.8%0.1%3.2%99.2%8650.0%982228650.0%

63252903540.0%138.2%0.0%0.0%1.3%100.0%8916.7%283518916.7%

7652341670232.0%144.8%2.3%1.4%3.8%97.7%99100.0%16980199100.0%

8539321458530.4%155.5%2.4%1.4%4.1%97.6%10075.0%4922610075.0%

978118050.0%161.3%1.3%0.1%7.7%98.8%14028.6%141335214028.6%

102779228818.2%173.1%0.7%0.1%2.8%99.3%14453.3%11297814453.3%

1131322634121.4%186.5%1.8%0.7%4.0%98.2%14640.0%171413214640.0%

121335214028.6%193.6%1.4%0.2%5.6%98.6%19662.5%1218061019662.5%

1339015841334.8%203.6%1.9%0.9%3.9%98.1%24355.6%52344524355.6%

141413214640.0%212.1%1.4%0.2%5.4%98.6%24511.8%1922815224511.8%5745176544.1%2.5%

152769529035.7%223.1%1.7%0.6%4.2%98.3%28415.0%1026417328415.0%

16922610075.0%232.0%6.0%2.5%13.1%94.0%28818.2%62779228818.2%

1717961019562.5%243.1%5.1%2.6%9.5%94.9%29135.7%152779529135.7%

1883228750.0%252.3%2.3%0.4%8.8%97.7%33518.2%l'ordine degli operatori corrisponde233249233518.2%

192334524255.6%261.7%2.1%0.8%5.0%97.9%34221.4%a quello della tabella a fianco:2231422634221.4%

2077128066.7%271.3%2.5%0.4%9.6%97.5%3540.0%operatore 1 = 24 nelle altre tabelle133252903540.0%

213411813605.3%285.0%0.3%0.0%1.8%99.7%3605.3%113411813605.3%

223249233518.2%292.7%0.6%0.1%2.4%99.4%41434.8%2139115841434.8%

2326417328415.0%306.0%1.1%0.3%3.3%98.9%46923.1%2645610346923.1%

2450215333.3%313.8%1.9%0.1%11.4%98.1%48423.3%2545423748423.3%

2545323748323.3%324.8%1.4%0.6%3.1%98.6%58430.4%8538321458430.4%

26456103469256.538461538523.1%332.1%0.6%0.2%2.0%99.4%70032.0%76503416700256.538461538532.0%22767490522.8%1.4%

Totale6588296117700128.3%344.2%1.7%1.4%2.0%98.3%700328.3%

Tabella 2 di OPERATOR per INDICA_CT

ControllodiSESSO=M

OPERATORINDICA_CTTotale

012CT appropriataCT inappropriata

Giovanni Bosco51535918.5%5.1%24523156

Maria Vittoria31303428.8%0.0%2452315625.0%3574364

Martini1143111832.5%0.8%357436442.9%206010575

Mauriziano800840.0%0.0%20601057533.3%18894093

Molinette45335155.9%5.9%188940930.0%9864494

S Giovanni Bos81628966.7%2.2%986449450.0%28686100

SGAS3610248720.8%4.2%2868610042.9%169654105

113015715231.8%89.9%4.6%2.0%9.6%95.4%5625.0%16965410544.4%382358737.7%3.9%4112141127

2868610042.9%98.0%6.0%2.5%13.1%94.0%6442.9%41121411276.7%1414460150

357436442.9%106.3%4.7%1.2%14.0%95.3%7533.3%14144601500.0%1130157152

41121411276.7%1111.0%0.8%0.0%5.0%99.2%930.0%113015715231.8%171711010191

5200261023627.8%1211.0%4.2%2.2%7.9%95.8%9450.0%17171101019150.0%12191275223

629024431814.3%137.5%1.3%0.4%3.4%98.7%10042.9%1219127522315.6%52002610236

7617534071043.0%147.5%5.6%4.1%7.7%94.4%10544.4%5200261023627.8%13656166629.2%3.4%19252253280

8553744367036.8%1511.0%6.4%4.7%8.6%93.6%1276.7%1925225328010.7%10271143288

987449550.0%164.2%4.2%1.4%11.0%95.8%1500.0%1027114328817.6%6290244318

1027114328817.6%174.9%1.0%0.3%3.3%99.0%15231.8%629024431814.3%15302253330

11341391639629.1%189.8%4.0%2.4%6.6%96.0%19150.0%1530225333010.7%23299448351

1218927522115.6%1912.2%2.3%0.8%5.5%97.7%22315.6%2329944835115.4%22333234360

1334620837428.6%205.3%2.1%1.0%4.3%97.9%23627.8%2233323436014.8%25358300618.6%1.9%13346208374

14143601490.0%214.0%0.0%0.1%3.1%100.0%28010.7%1334620837428.6%280133350132.2%3.8%113403916395

1530325333110.7%227.6%0.9%0.2%2.9%99.1%28817.6%11340391639529.1%213714014425

16965410544.4%234.8%3.8%1.2%10.0%96.2%31814.3%l'ordine degli operatori corrisponde21371401442525.9%26424233450

17171101019150.0%245.2%5.2%2.7%9.7%94.8%33010.7%a quello della tabella a fianco:2642423345011.5%25438319478

188840920.0%254.3%0.0%0.1%5.0%100.0%35115.4%operatore 1 = 24 nelle altre tabelle2543831947822.5%85537443670

1925425328210.7%268.9%1.1%0.3%3.3%98.9%36014.8%8553744367036.8%382118471923.6%2.5%76165340709

20601057533.3%2713.3%6.7%2.5%15.5%93.3%37428.6%7616534070943.0%435158471926.6%3.3%

21370401442425.9%289.4%3.3%1.9%5.6%96.7%39529.1%272.8461538462

2233323436014.8%296.4%1.1%0.4%3.0%98.9%42525.9%22793279229.1%

2329944835115.4%3012.5%2.3%1.1%4.6%97.7%45011.5%

2452315625.0%315.4%1.8%0.1%10.8%98.2%47822.5%

2543831947822.5%326.5%1.9%0.9%3.7%98.1%67036.8%

2642423345011.5%335.1%0.7%0.2%2.1%99.3%70943.0%

Totale6676601225750227.2%348.0%3.0%2.6%3.4%97.0%750227.2%

Tabella 1 di OPERATOR per class_size

ControllodiSESSO=F

OPERATORclass_sizeTotale

0123negativeany polyp1-5 mm6-9 mm>=10 mm

Giovanni Bosco327114178.0%22.0%11.1%38.0%78.0%17.1%2.4%2.4%

Maria Vittoria275103381.8%18.2%7.6%36.1%81.8%15.2%3.0%0.0%

Martini854149490.4%9.6%4.7%17.8%90.4%4.3%1.1%4.3%

Mauriziano4110666.7%33.3%6.0%75.9%66.7%16.7%16.7%0.0%

Molinette482125390.6%9.4%3.5%21.4%90.6%3.8%1.9%3.8%

S Giovanni Bos616217087.1%12.9%6.4%23.5%87.1%8.6%2.9%1.4%

SGAS321033688.9%11.1%3.6%27.0%88.9%2.8%0.0%8.3%

1118109714481.9%18.1%12.3%25.5%81.9%5.0%6.9%6.3%4.9%

2888129988.9%11.1%5.9%19.4%88.9%5.5%8.1%1.0%2.0%

3562246487.5%12.5%5.9%23.7%87.5%7.5%3.1%3.1%6.3%

4787048987.6%12.4%6.6%21.4%87.6%7.5%7.9%0.0%4.5%

52092111424585.3%14.7%10.6%19.9%85.3%7.9%8.6%0.4%5.7%

62755941635477.7%22.3%18.2%27.1%77.7%8.3%16.7%1.1%4.5%

76333443170290.2%9.8%7.8%12.3%90.2%8.4%4.8%0.6%4.4%

8441108152158575.4%24.6%21.2%28.4%75.4%9.8%18.5%2.6%3.6%

9763018095.0%5.0%1.6%13.0%95.0%11.1%3.8%0.0%1.3%

10264171628891.7%8.3%5.5%12.3%91.7%12.2%5.9%0.3%2.1%

1127541101534180.6%19.4%15.4%24.0%80.6%12.3%12.0%2.9%4.4%

12115181614082.1%17.9%12.1%25.4%82.1%12.4%12.9%0.7%4.3%

133464491441383.8%16.2%12.9%20.2%83.8%12.5%10.7%2.2%3.4%

1413562314692.5%7.5%4.0%13.4%92.5%13.2%4.1%1.4%2.1%

1524820111129085.5%14.5%10.7%19.2%85.5%14.4%6.9%3.8%3.8%

1680172110080.0%20.0%12.9%29.4%80.0%14.5%17.0%2.0%1.0%

17163178719583.6%16.4%11.7%22.5%83.6%14.7%8.7%4.1%3.6%

18745358785.1%14.9%8.5%24.6%85.1%14.9%5.7%3.4%5.7%

19223124324292.1%7.9%4.9%12.2%92.1%16.2%5.0%1.7%1.2%

20744118092.5%7.5%3.1%16.2%92.5%16.4%5.0%1.3%1.3%

2130825151236085.6%14.4%11.1%18.6%85.6%17.9%6.9%4.2%3.3%

22307164833591.6%8.4%5.7%12.0%91.6%18.1%4.8%1.2%2.4%

232491911528487.7%12.3%8.8%16.9%87.7%19.4%6.7%0.4%5.3%

24463225386.8%13.2%5.9%26.0%86.8%20.0%5.7%3.8%3.8%

254243991148387.8%12.2%9.5%15.6%87.8%22.3%8.1%1.9%2.3%

26443143946992094.5%5.5%3.7%8.1%94.5%24.6%3.0%0.6%1.9%

Totale6037595129240700186.2%13.8%13.0%14.6%86.2%8.5%1.8%3.4%

Tabella 2 di OPERATOR per class_size12.9%


OPERATORclass_sizeTotale14.9%

0123negativeany polyp1-5 mm6-9 mm>=10 mm

Giovanni Bosco439255972.9%27.1%16.7%40.5%72.9%15.3%3.4%8.5%

Maria Vittoria282133482.4%17.6%7.4%35.2%82.4%5.9%2.9%8.8%

Martini10680411889.8%10.2%5.6%17.4%89.8%6.8%0.0%3.4%

Mauriziano6101875.0%25.0%4.5%64.4%75.0%12.5%0.0%12.5%

Molinette3711305172.5%27.5%16.3%42.0%72.5%21.6%5.9%0.0%

S Giovanni Bos5724448964.0%36.0%26.3%46.9%64.0%27.0%4.5%4.5%

SGAS345274870.8%29.2%17.4%44.3%70.8%10.4%4.2%14.6%

111016101615272.4%27.6%20.8%35.6%72.4%12.1%10.5%6.6%10.5%

267196810067.0%33.0%24.1%43.2%67.0%13.9%19.0%6.0%8.0%

34910236476.6%23.4%14.1%36.0%76.6%15.3%15.6%3.1%4.7%

4951841012774.8%25.2%18.1%33.8%74.8%15.6%14.2%3.1%7.9%

51713252823672.5%27.5%22.0%33.8%72.5%16.1%13.6%2.1%11.9%

622367121631870.1%29.9%25.0%35.3%70.1%17.2%21.1%3.8%5.0%

758855244371082.8%17.2%14.5%20.2%82.8%18.9%7.7%3.4%6.1%

8386205374267057.6%42.4%38.6%46.2%57.6%19.0%30.6%5.5%6.3%

97713239581.1%18.9%11.9%28.6%81.1%20.6%13.7%2.1%3.2%

102443031128884.7%15.3%11.4%20.1%84.7%20.9%10.4%1.0%3.8%

1125491213039664.1%35.9%31.2%40.8%64.1%21.4%23.0%5.3%7.6%

121632592422173.8%26.2%20.7%32.7%73.8%21.5%11.3%4.1%10.9%

1329651151237479.1%20.9%16.9%25.4%79.1%23.4%13.6%4.0%3.2%

1413165714987.9%12.1%7.5%18.7%87.9%23.6%4.0%3.4%4.7%

1526030202133178.5%21.5%17.2%26.3%78.5%23.9%9.1%6.0%6.3%

1678242110574.3%25.7%17.9%35.3%74.3%25.2%22.9%1.9%1.0%

1714619161019176.4%23.6%17.9%30.3%76.4%25.7%9.9%8.4%5.2%

18708959276.1%23.9%15.9%34.1%76.1%25.9%8.7%9.8%5.4%

1922431121528279.4%20.6%16.1%25.9%79.4%26.2%11.0%4.3%5.3%

204713787562.7%37.3%26.7%49.3%62.7%27.5%17.3%9.3%10.7%

2131457223142474.1%25.9%21.9%30.4%74.1%27.6%13.4%5.2%7.3%

223102262236086.1%13.9%10.6%18.0%86.1%29.9%6.1%1.7%6.1%

232762294435178.6%21.4%17.3%26.1%78.6%33.0%6.3%2.6%12.5%

24473245683.9%16.1%8.1%28.8%83.9%35.9%5.4%3.6%7.1%

25387621316478170281.0%19.0%15.7%22.9%81.0%37.3%13.0%2.7%3.3%

263804342345084.4%15.6%12.4%19.3%84.4%42.4%9.6%0.9%5.1%

Totale57041032289477750276.0%24.0%23.0%25.0%76.0%13.8%3.9%6.4%

Tabella 1 di OPERATOR per ad_dist23.5%


OPERATORad_distTotale25.9%

01adenomi - donne

Giovanni Bosco7344117.1%

Maria Vittoria330339.1%

Martini589945.3%

Mauriziano15616.7%

Molinette350535.7%


SGAS333368.3%uomini

arrigoni11812614419.3%7.8%12.5%7.8%19.3%87.5%2.5%12.5%

bertone26939913.2%2.5%6.1%2.5%13.2%93.9%2.5%21.0%

bruno36586419.9%3.9%9.4%3.9%19.9%90.6%2.8%6.3%

caronna46838914.6%2.8%6.7%2.8%14.6%93.3%3.8%11.8%

cavallero52522024514.9%6.8%10.2%6.8%14.9%89.8%4.2%14.0%

coppola64231235415.8%8.8%11.9%8.8%15.8%88.1%4.8%15.4%

cosimato7466567028.7%4.9%6.6%4.9%8.7%93.4%4.9%10.7%

di placido88350258517.3%11.5%14.2%11.5%17.3%85.8%5.7%24.9%

ferraris9278805299.6%0.4%2.5%0.4%9.6%97.5%6.1%15.8%

formento10142742888.2%2.8%4.9%2.8%8.2%95.1%6.6%8.0%

fracchia1136305341arrigoni12.5%14.4%7.6%10.6%7.6%14.4%89.4%6.7%18.9%

galatola1217123140bertone13.6%19.0%7.4%12.1%7.4%19.0%87.9%7.2%17.6%

garr

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