Do socioeconomic factors play a role in nonadherence to follow-up colonoscopy after a positive faecal immunochemical test in the Flemish colorectal cancer screening programme?

2020 ◽  
Vol 29 (2) ◽  
pp. 119-126 ◽  
Author(s):  
S. Hoeck ◽  
W. van de Veerdonk ◽  
I. De Brabander
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Socioeconomic Factors ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Faecal Immunochemical Test ◽  
Cancer Screening Programme ◽  
Immunochemical Test

scholarly journals Interval cancers after negative immunochemical test compared to screen and non-responders’ detected cancers in Slovenian colorectal cancer screening programme

2018 ◽  
Vol 52 (4) ◽  
pp. 413-421 ◽  
Author(s):  
Dominika Novak Mlakar ◽  
Tatjana Kofol Bric ◽  
Ana Lucija Škrjanec ◽  
Mateja Krajc
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Test ◽  
Screening Programme ◽  
Interval Cancers ◽  
Faecal Immunochemical Test ◽  
Test Sensitivity ◽  
Cancer Screening Programme ◽  
Immunochemical Test

Abstract Background We assessed the incidence and characteristics of interval cancers after faecal immunochemical occult blood test and calculated the test sensitivity in Slovenian colorectal cancer screening programme. Patients and methods The analysis included the population aged between 50 to 69 years, which was invited for screening between April 2011 and December 2012. The persons were followed-up until the next foreseen invitation, in average for 2 years. The data on interval cancers and cancers in non-responders were obtained from cancer registry. Gender, age, years of schooling, the cancer site and stage were compared among three observed groups. We used the proportional incidence method to calculate the screening test sensitivity. Results Among 502,488 persons invited for screening, 493 cancers were detected after positive screening test, 79 interval cancers after negative faecal immunochemical test and 395 in non-responders. The proportion of interval cancers was 13.8%. Among the three observed groups cancers were more frequent in men (p = 0.009) and in persons aged 60+ years (p < 0.001). Comparing screen detected and cancers in non-responders with interval cancers more interval cancers were detected in persons with 10 years of schooling or more (p = 0.029 and p = 0.001), in stage III (p = 0.027) and IV (p < 0.001), and in right hemicolon (p < 0.001). Interval cancers were more frequently in stage I than non-responders cancers (p = 0.004). Test sensitivity of faecal immunochemical test was 88.45%. Conclusions Interval cancers in Slovenian screening programme were detected in expected proportions as in similar programmes. Test sensitivity was among the highest when compared to similar programmes and was accomplished using test kit for two stool samples.

Colonoscopy may be weak link in organised colorectal cancer screening programme with faecal immunochemical test

2021 ◽  
pp. 096914132110611
Author(s):  
Bernard Denis ◽  
Isabelle Gendre
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Lesion Detection ◽  
Faecal Immunochemical Test ◽  
Adenoma Detection ◽  
Cancer Screening Programme ◽  
Immunochemical Test ◽  
Serrated Lesion

Objective To evaluate the quality of colonoscopies performed after a positive faecal immunochemical test in the French colorectal cancer screening programme. Methods Retrospective analysis of all colonoscopies performed between 2015 and 2019 after a positive quantitative faecal immunochemical test in the population-based colorectal cancer screening programme organised in Alsace, part of the French programme. The following indicators were evaluated: annual colonoscopy volume, caecal intubation rate, adenoma detection rate, proximal serrated lesion detection rate and proportion of patients referred directly to surgery for benign polyp management. Endoscopists who performed <30 faecal immunochemical test positive colonoscopies were non-assessable. Results Overall, 13,455 faecal immunochemical test-positive colonoscopies performed by 116 community gastroenterologists were included, 13,067 of them by 80 assessable endoscopists. The overall caecal intubation, adenoma detection and proximal serrated lesion detection rates were 97.9%, 57.6% and 7.6%, respectively. They were <90%, <45% and <1% for 1.3%, 12.5% and 6.3% of the endoscopists, respectively. Overall, 1028 (7.9%) individuals were examined by 13 low-performing endoscopists and 328 (2.4%) individuals by 33 low-volume non-assessable endoscopists. Among 9133 individuals harbouring polyps, 155 (1.7%) had unwarranted surgery for a benign polyp. Overall, 1487 individuals (11.1%; 95% confidence interval 10.5–11.6) were not given the best possible chances, whereas 5545 individuals (41.2%; 95% confidence interval 40.4–42.0) were offered the best possible chances by 37 endoscopists. Conclusions At programme level, the key performance indicators evaluated largely exceeded the target standards. At individual level, at least one in nine individuals was not given the best possible chances during faecal immunochemical test-positive colonoscopies by a minority of poor-performing and/or low-volume endoscopists.

Faecal immunochemical test-based colorectal cancer screening programme SVIT in Slovenia

2014 ◽  
Vol 23 (4) ◽  
pp. 235-239 ◽  
Author(s):  
Bojan Tepeš ◽  
Borut Štabuc ◽  
Milan Stefanovič ◽  
Matej Bračko ◽  
Snežana Frkovič Grazio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Faecal Immunochemical Test ◽  
Cancer Screening Programme ◽  
Immunochemical Test

scholarly journals Factors related to the participation and detection of lesions in colorectal cancer screening programme-based faecal immunochemical test

2018 ◽  
Vol 28 (6) ◽  
pp. 1143-1148 ◽  
Author(s):  
Isabel Portillo ◽  
Eunate Arana-Arri ◽  
Iñaki Gutiérrez-Ibarluzea ◽  
Isabel Bilbao ◽  
Jose Luis Hurtado ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Faecal Immunochemical Test ◽  
Cancer Screening Programme ◽  
Immunochemical Test

Stable prevalence of faecal immunochemical test positivity over time in Italy

2019 ◽  
Vol 27 (3) ◽  
pp. 168-169
Author(s):  
Manuel Zorzi ◽  
Jessica Battagello ◽  
Massimo Rugge
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Latex Agglutination ◽  
Faecal Immunochemical Test ◽  
North East ◽  
Cancer Screening Programme ◽  
Immunochemical Test ◽  
Over Time

Objectives The prevalence of guaiac faecal occult blood positivity among participants aged 50 in the Scottish Bowel Screening Programme showed a significant increase from 2007 to 2017. As a comparison, we examined the trend in the prevalence of faecal immunochemical test (FIT) positivity among participants aged 50 in the colorectal cancer screening programme of the Veneto region (north-east Italy) from 2006 to 2018. Methods The target population includes residents aged 50–69, who are invited to repeat the FIT every two years. The screening programme uses the OC-Hemodia latex agglutination test, with a cut-off for positivity of 20 µg of haemoglobin per g of faeces. Results Based on 182,275 FITs performed on participants aged 50, overall FIT positivity was 3.6% in 2006 (95% confidence interval (CI): 3.1–4.2) and 3.7% (95% CI: 3.4–3.9) in 2018, showing no significant trend ( p = 0.19). The prevalence of positive test results was higher in males throughout the study period. No gradient was seen for men (2006 = 4.4%, 95% CI: 3.6–5.3; 2018 = 4.2%, 95% CI: 3.9–4.6; p = 0.10) or women (2006 = 2.8%, 95% CI: 2.1–3.5; 2018 = 3.2%, 95% CI: 2.9–3.5; p = 0.84). Conclusions In a FIT-based colorectal cancer screening programme in Italy, the test positivity over time was stable. Our findings suggest that the interpretation of faecal haemoglobin levels may not be geographically transferable.

scholarly journals A prospective study of faecal immunochemical testing following polypectomy in a colorectal cancer screening population

2017 ◽  
Vol 9 (4) ◽  
pp. 295-299 ◽  
Author(s):  
David J Gibson ◽  
Blathnaid Nolan ◽  
Joanna Rea ◽  
Maire Buckley ◽  
Gareth Horgan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Clinical Findings ◽  
Adenomatous Polyps ◽  
Screening Colonoscopy ◽  
Cancer Screening Programme ◽  
Advanced Adenomas

Introduction52% of faecal immunohistochemistry test (FIT)-positive clients in the Irish National Colorectal Cancer Screening Programme (BowelScreen) have adenomatous polyps identified at colonoscopy in round 1. Although it is known that advanced adenomas and cancers cause an elevated FIT, it is not known if small (<5 mm) adenomas cause a positive FIT.AimsDetermine if removal of small polyps in an FIT-based colorectal cancer (CRC) screening programme is associated with a negative FIT on follow-up.MethodsA single-centre prospective observational study of consecutive participants attending for first round screening colonoscopy who had a positive FIT (>45 µg Hb/g) as part of the Irish Colorectal Cancer Screening Programme. Subjects were consented at the time of colonoscopy and were sent a repeat FIT 4–6 weeks later. Precolonoscopy and postcolonoscopy FITs were compared and correlated with clinical findings and endoscopic intervention.Results112 consecutive first round participants were recruited. Eight (7%) had cancer, 75 (67%) adenomatous polyps, 17 (15%) a normal colonoscopy and 12 (11%) other pathology. There was a clear difference in median FIT levels between the four groups (P=0.006). Advanced pathology (tumour or adenomatous polyp >1 cm) was associated with higher FIT than non-advanced pathology (median FIT 346 vs 89 P=0.0003). 83% (86/104) of subjects completed a follow-up FIT. Follow-up FIT remained positive in 20% (17/86). Polypectomy was associated with a reduction in FIT from a median of 100 to 5 µg Hb/g (P<0.0001). Removal of polyps >5 mm was the only factor independently associated with a negative follow-up FIT on multivariate analysis (OR 3.9 (1.3–11.9, P=0.04)).ConclusionFIT is a sensitive test and levels increase with advanced colonic pathology. Polypectomy of advanced adenomas is associated with a negative follow-up FIT. However, alternative causes for a positive FIT should be considered in patients who have adenomas less than 5 mm detected or a normal colonoscopy.

scholarly journals Does self-reported symptom questionnaire play a role in nonadherence to colonoscopy for risk-increased population in the Tianjin colorectal cancer screening programme?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lizhong Zhao ◽  
Xiaorui Zhang ◽  
Yongjie Chen ◽  
Yuan Wang ◽  
Weihua Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Cancer History ◽  
Symptom Questionnaire ◽  
Cancer Screening Programme ◽  
Immunochemical Test ◽  
Potential Factors ◽  
Potential Cancer

Abstract Background A colorectal cancer screening programme (CCSP) was implemented from 2012 to 2017 in Tianjin, China. Residents with a positive faecal immunochemical test (FIT) or positive self-reported symptom questionnaire (SRSQ) were recommended to undergo colonoscopy. The objective was to investigate the potential factors associated with nonadherence to colonoscopy among a risk-increased population. Methods Data were obtained from the CCSP database, and 199,522 residents with positive FIT or positive SRSQ during two screening rounds (2012–2017) were included in the analysis. Logistic regression analysis was performed to assess the association between nonadherence to colonoscopy and potential predictors. Results A total of 152,870 (76.6%) individuals did not undergo colonoscopy after positive FIT or positive SRSQ. Residents with positive SRSQ but without positive FIT were more likely not to undergo colonoscopy (negative FIT: OR, 2.35; 95% CI, 2.29–2.41, no FIT: OR, 1.27; 95% CI, 1.24–1.31). Patients without a cancer history were less likely to undergo colonoscopy even if they received risk-increased reports based on the SRSQ. Conclusion In the CCSP, seventy-seven percent of the risk-increased population did not undergo colonoscopy. FIT should be recommended since positive FIT results are related to improved adherence to colonoscopy. Residents with negative FIT but positive SRSQ should be informed of the potential cancer risk to ensure adherence to colonoscopy.

scholarly journals Adverse events of colonoscopy in a colorectal cancer screening programme with faecal immunochemical test: a population-based community-based observational study

2020 ◽  
Author(s):  
Bernard Denis ◽  
Isabelle Gendre ◽  
Sarah Weber ◽  
Philippe Perrin
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Adverse Events ◽  
Observational Study ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Population Based ◽  
Community Based ◽  
Cancer Screening Programme ◽  
Immunochemical Test

ABSTRACTObjectivesColonoscopy is considered a safe examination, serious complications being uncommon. Our study aimed to assess the adverse events of colonoscopy in a colorectal cancer screening programme with faecal immunochemical test (FIT) and to compare them with those of a previous programme with guaiac-based faecal occult blood test (gFOBT).DesignRetrospective observational studySettingPopulation-based community-based colorectal cancer screening programme organised in Alsace, part of the national French programme, with FIT from 2015 to 2018 and gFOBT from 2003 to 2014.ParticipantsAll residents aged 50 – 74 years having a colonoscopy performed for a positive FOBT.Main outcome measuresAdverse events were recorded through prospective voluntary reporting by community gastroenterologists and retrospective postal surveys addressed to persons screened.ResultsOf 9576 colonoscopies performed for a positive FIT, 6194 (64.7%) were therapeutic. Overall, 180 adverse events were recorded (18.8‰, 95% CI 16.1-21.5), 114 of them (11.9‰, 95% CI 9.7-14.1) requiring hospitalisation, 55 (5.7‰, 95% CI 4.2-7.3) hospitalisation >24hrs, and 8 (0.8‰, 95% CI 0.3-1.4) surgery. The main complications requiring hospitalisation were perforation (n=18, 1.9‰, 95% CI 1.0-2.7) and bleeding (n=31, 3.2‰, 95% CI 2.1-4.4). We observed one death (1 / 27,000 colonoscopies). Overall, 52 persons harbouring at least one adenoma ≥ 10 mm were detected for one adverse event requiring hospitalisation >24hrs. The rate of adverse events remained stable between gFOBT and FIT programmes.ConclusionsThe harms of colonoscopy in a colorectal cancer screening programme with FIT are more frequent than usually estimated, here six adverse events requiring hospitalisation >24hrs (three bleedings, two perforations), one necessitating surgery and 50 minor complications per 1000 colonoscopies. The price to be paid to save lives through colorectal cancer screening programmes is higher than what is stated in most pilots. Today, comparison between series dealing with colonoscopy-related adverse events is almost impossible.

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