scholarly journals Improving participation of detained men in organised screening of colorectal cancer in Toulon

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Porte ◽  
M D Harmel ◽  
L Pernice ◽  
M Misserey ◽  
C Adam ◽  
...  

Abstract In France, organised screening for colorectal cancer was set up in 2008. Participation rate was assessed in March 2014 at the prison of Toulon / La Farlède. On the 100 detained men aged 50-74 years old concerned by screening, only 3.9 % were screened. A project aiming at improving participation in screening while addressing specific difficulties related to prison settings (lack of privacy in cells, low socioeconomic and education status of the population, stronger exposition to risk factors for colorectal cancer) was launched in 2015 and has been yearly conducted since then. How to improve colorectal cancer screening in a prison setting? How to organise a sustainable screening program? What proximity guidance should be provided to foster participation? The program that was developed mainly consisted in awareness sessions and proximity guidance to testing. Among the 330 detained men targeted between 2015 and 2018, 165 men performed an immunologic test (57.9%) and 45 were excluded for medical reasons. Colonoscopy was performed for 10 of the 13 men with a positive result and lesions were detected for 9 men. Among them, one cancer, 6 high-risk polyps and 2 low-risk polyps were found. Those findings exceeded expected numbers. Despite a small population sample, data revealed the benefit of the project in comparison with other participation rates: only 33.5% in France and 29.3% in the Var department (estimates for 2016-17 by Santé Publique France). Furthermore, we achieved a participation rate compliant with European recommendations establishing 45% as a minimum target. The success of our program relied on the synergy between health prevention professionals screening organisers and prison medical staff. Strong involvement of each team constituted a real leverage for project to ensure effective proximity guidance for detained persons leading them to get screened. Key messages Awareness program adapted to prison improved participation in colorectal cancer organised screening. Proximity guidance helped to detect cancer and to improve medical care of detained persons.

2021 ◽  
Vol 14 (7) ◽  
Author(s):  
Pegah Mohaghegh ◽  
Farzane Ahmadi ◽  
Mahjabin Shiravandi ◽  
Javad Nazari

Background: Colorectal cancer (CRC) is among the most common and preventable cancers, the incidence and risk factors of which are different in various populations. Objectives: The present study aims at assessing incidence rate, risk factors, and symptoms of CRC among the populations aged 50 to 70 years old covered by the health centers in Arak, as well as evaluating participation rate in the CRC screening program. Methods: The present cross-sectional study was conducted from 2016 to 2019 among all of the individuals aged 50 to 70 years old, who were referred to rural, urban, and suburban health centers in Arak for CRC screening, and their data were recorded in the Sib system. The participation rate, risk factors (family and individual history of CRC, colorectal adenoma, and inflammatory bowel disease), symptoms (lower gastrointestinal bleeding, constipation with or without diarrhea, and weight loss), and crude incidence rate of CRC were calculated in the age range. Results: The mean (SD) age of the CRC was 59.72 (5.56) years. In addition, the individuals’ participation rate in the program was about 44.2%, which was more among women (55.5%) and villagers (93.7%). Most subjects complained of constipation in the last month and CRC family history. The CRC crude incidence rates were 35.93 (95% CI: 25.55 - 50.54), 40.96 (95% CI: 29.81 - 56.29), 43.76 (95% CI: 32.22 - 59.43), and 52.84 (95% CI: 40.05 - 69.71) per 100000 individuals during 2016, 2017, 2018, and 2019, respectively. Conclusions: The participation rate in the CRC screening program was low, and the trend of the cancer crude incidence rate increased among the populations aged 50 to 70 years. Finally, informing about the recognition of the risk factors and symptoms of cancer, as well as the timely referral for screening was considered essential.


2017 ◽  
Vol 158 (42) ◽  
pp. 1658-1667
Author(s):  
Mariann Rutka ◽  
Tamás Molnár ◽  
Renáta Bor ◽  
Klaudia Farkas ◽  
Anna Fábián ◽  
...  

Abstract: Introduction: In Hungary, a nationwide colorectal screening program is about to be introduced in order to improve the extremely high mortality rate of colorectal cancer (CRC). Aim: The aim of our study was to summarize experiences and assess short-term efficacy of the population-based pilot colorectal screening program in 2015 in Csongrád County, Hungary. Patients and method: Asymptomatic individuals between the ages of 50 and 70 with average risk of colorectal cancer participated in the program that was based on the two-step screening method (i.e. immune fecal blood test and colonoscopy). The short-term efficacy of the screening program was assessed as the change in total CRC incidence and initial tumor stage in the screening year (2015) compared to a control year (2013) in Szeged and its surroundings. Participation rate, positive predictive value of the screening methods and tumor detection rate was assessed. Results: 22,130 individuals were invited, the participation rate was 46.4%. Immune fecal blood test proved to be non-negative in 1,343 cases (13%), screening colonoscopy was performed in 766 of them (7.5%). Total colonoscopy was performed in 711 individuals. Based on the reports, adenoma was detected in 358 (50.3%) and malignancy in 42 (5.9%) individuals. In the background population, the incidence of colon cancer was significantly higher (183 vs. 228; p = 0.026) and was diagnosed at significantly earlier stage (p = 0.002). Lymph node involvement was significantly lower in 2015 (48.3% vs. 37.1%; p = 0.049). Conclusion: The Csongrád county population-based colorectal cancer screening was evidently successful on the short term considering participation rate, and the changes in CRC incidence and stage, thus its national extension is necessary. Orv Hetil. 2017; 158(42): 1658–1667.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Barre ◽  
H Leleu ◽  
S Taleb ◽  
A Vimont

Abstract Introduction Colorectal cancer (CRC) is the third most common cancer and the second most deadly in France. A CRC national organized screening (OS) program was set up in France in 2009. It targets asymptomatic people aged 50 to 74 year with medium risk of CRC. OS program is based on fecal immunochemical test (FIT) followed by colonoscopy. Participation rate over the last period showed a participation rate of 34%, far from the European standards and the 45% target objective of the French cancer plan. Methods The epidemiological impact of the DO-CCR was estimated from the results of an individual simulation model adapted from the MISCAN-Colon model, calibrated and transposed to the French context. The model simulates the natural history of CRC in a cohort of 5,000,000 individuals from birth to death. The simulated population reproduced the age and sex structure of the French population. Current screening strategy was simulated for the entire population. A first analysis was conducted to estimate the individual impact of screening by sex and by age of screening initiation and cessation. A second analysis was carried out to estimate the global impact of the based on various participation rates. Results FIT every 2 years, from the age of 50, is associated with a reduction in the CRC incidence of 21% for women and 24% for men and a reduction in CRC mortality of 43% for women and 51% for men. At the current level of participation, the OS reduces incidence by 5% and mortality by 14% (2,200 CCR and 2,600 deaths per year) compared to no OS. The impact would be reduced by an additional 3% and 8% for participation rates of 45% and 65% respectively, a decrease of 1,300 and 3,500 cases per additional year. Similarly, mortality would decrease by an additional 8% and 22% for participation rates of 45% and 65%, respectively additional decreases of 1,400 and 4,000 deaths per year. Key messages These results confirm that in a population at medium risk for CRC, the OS is an effective strategy for reducing incidence of CRC. Increasing participation rate to reach the Cancer Plan’s objectives remains a key issue in France.


2016 ◽  
Vol 73 (4) ◽  
pp. 360-367 ◽  
Author(s):  
Dusica Bankovic-Lazarevic ◽  
Zoran Krivokapic ◽  
Goran Barisic ◽  
Verica Jovanovic ◽  
Dragan Ilic ◽  
...  

Background/Aim. The National Organized Colorectal Cancer Screening Program was conducted in the Republic of Serbia during 2013-2014 covering the population of both genders, aged 50 to 74 years, in 28 municipalities out of 180, with the target population of 651,445 people. This organized colorectal cancer screening aims to reduce mortality from colorectal cancer in the target population. The aim of this study was to show the results of organized screening for colorectal cancer during the first biannual round in Serbia. Methods. General practitioners from the primary health centers, invited target population by letters and by phone to perform immunochemical fecal occult blood test. Persons with a positive test results were referred to the colonoscopy. The database of health insurance and other citizens of the target population was used for invitation for screening in primary health centers. Descriptive statistical analysis of the results in organized colorectal cancer screening in the first round was performed for the key screening indicators. Results. In the first round, a total of 99,592 persons were invited. The participation rate was 62.5%. Colonoscopy was performed in 1,554 persons. Adenomas were found in 586 persons (0.9% of all the tested), e.g. 37.7 % of all colonoscopied. In 129 persons colorectal cancer was diagnosed (0.2% of all the tested), e.g. 8.3% of all the colonoscopied. In the left half of the colon (rectum, sigmoid and descending colon) there were 70.4% diagnosed polyps and 77.3% carcinomas, while 29.6% of polyps and 22.7% carcinomas were found in the proximal parts of the colon. Conclusion. In the first round of the organized colorectal cancer screening in Serbia the participation rate of the targeted population was high and gave encouraging result. It was expected that in the forthcoming rounds even higher coverage of the target population would be accomplished. A positive predictive value of the completed colonoscopies showed that further work on observing the stages of diagnosed adenomas and carcinomas would reach the goals of the expected improvement in early detection of colorectal cancer in Serbia.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Arlotto ◽  
E Le Cozannet ◽  
Y Rinaldi ◽  
S Gentile ◽  
P Heid ◽  
...  

Abstract Background The National Organized Colorectal Cancer Screening Program (DOCCR) was introduced in 2008. The participation rate in France is much lower than the European recommendations (33.5% versus 45%). There are significant disparities across France. The objective was to assess whether there are disparities in participation rates within the Bouches-du-Rhône(BdR) department and to study the possible correlation of these geographical areas with their level of precariousness. Methods Based on data collected by the ARCADES association (management structure in charge of cancer screening in the BdR region), 325,207 people in 2012 and 489,953 in 2017 were invited to participate in the DOCCR. The participation was analysed in two aspects: participation rate (TP) (test carried out) and participation rate of those who took a test or expressed a justified refusal (TPJ) (personal or family history, other test under 2 years old, colonoscopy under 5 years old). An average precariousness rate was also assessed per municipality based on 2012 INSEE data for the age group concerned. Results The TP were 18.9% in 2012 and 14.4% in 2017; the TPJ were 22.8% and 16.4% respectively and differs significantly between the municipalities in the department (p < 0.001). The average precariousness rate observed in our population was 12.3 (±8.2). The TPJ is inversely correlated with the precariousness rate: the higher the latter, the lower the participation rate (R=-0.58 in 2012, R=-0.539 in 2017; p < 0.05). The average participation rate whatever the year is lower for municipalities with a precariousness rate below the median (19.2 ± 2 versus 16.9 ± 3.5 for the year 2017). Conclusions Participation rates in 2012 and 2017 are lower than the European recommendations. The participation is significantly related to the average rate of precariousness; the most vulnerable participate less well. Specific actions towards the most vulnerable are to be considered in order to improve adherence to the DOCCR. Key messages The participation organized colorectal cancer screening program is significantly related to the average rate of precariousness. Specific actions towards the most precarious are to be considered in order to improve adherence to the DOCCR.


2015 ◽  
Vol 24 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Elena Mirela Ionescu ◽  
Tudor Nicolaie ◽  
Serban Ion Gologan ◽  
Ana Mocanu ◽  
Cristina Ditescu ◽  
...  

Background & Aims: Even though Romania has one of the highest incidence and mortality in colorectal cancer (CRC) in Europe, there is currently no organized screening program. We aimed to assess the results of our opportunistic CRC screening using colonoscopy.Methods: A single center retrospective study to include all opportunistic screening colonoscopies performed in two 18 month periods (2007-2008 and 2012-2013) was designed. All asymptomatic individuals without a personal or family history of adenoma or CRC and with complete colonoscopy performed in these two time periods were included.Results: We included 1,807 individuals, 882 in the first period, 925 in the second period. There were 389 individuals aged below 50, 1,351 between 50 and 75 and 67 older than 75 years. There were 956 women (52.9%), with a mean age of 58.5 (median 59, range 23-97). The detection rates were 12.6% for adenomas (6.1% for advanced adenoma) and 3.4% for adenocarcinoma. Adenoma incidence (4.9% in subjects under 50, 14.7% in those aged 50 to 75, and 16.4% in those older than 75, p<0.0001) and size (6.3mm in subjects younger than 50, 9.2mm in those 50 to 75 and 10.8mm in those older than 75, p=0.015) significantly increased with age. Adenoma incidence increased in the second period (14.8% vs. 10.3%, p=0.005), while adenoma size decreased in the second period (8.4mm vs. 10mm, p=0.006). There were no procedure related complications.Conclusions: The neoplasia detection rate was 16% (12.6% adenoma, 3.4% adenocarcinoma). Adenoma incidence and size increased with age in both cohorts. In the second screening period significantly more and smaller adenomas were detected.


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