Colorectal Cancer Screening: How Health Gains and Cost-Effectiveness Vary by Ethnic Group, the Impact on Health Inequalities, and the Optimal Age Range to Screen

We aimed to report the results of the implementation of the National Colorectal Cancer (CRC) Screening Program covering all the country. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the program has its own administrative code. Information about services provided within the program was retrieved from the database of NHIF starting from the 1 January 2014 to the 31 December 2018. Exact date and type of all provided services, test results, date and results of biopsy and histopathological examination were extracted together with the vital status at the end of follow-up, date of death and date of emigration when applicable for all men and women born between 1935 and 1968. Results were compared with the guidelines of the European Union for quality assurance in CRC screening and diagnosis. The screening uptake was 49.5% (754,061 patients) during study period. Participation rate varied from 16% to 18.1% per year and was higher among women than among men. Proportion of test-positive and test-negative results was similar during all the study period—8.7% and 91.3% annually. Between 9.2% and 13.5% of test-positive patients received a biopsy of which 52.3–61.8% were positive for colorectal adenoma and 4.6–7.3% for colorectal carcinoma. CRC detection rate among test-positive individuals varied between 0.93% and 1.28%. The colorectal cancer screening program in Lithuania coverage must be improved. A screening database is needed to systematically evaluate the impact and performance of the national CRC screening program and quality assurance within the program.

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Are there ethnic and religious variations in uptake of bowel cancer screening? A retrospective cohort study among 1.7 million people in Scotland

BMJ Open ◽

10.1136/bmjopen-2020-037011 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037011

Author(s):

Christine Campbell ◽

Anne Douglas ◽

Linda Williams ◽

Geneviève Cezard ◽

David H Brewster ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Ethnic Group ◽

Colorectal Cancer Screening ◽

South Asian ◽

Bowel Cancer ◽

Index Number ◽

Adjusted Risk ◽

Targeted Interventions ◽

Bowel Cancer Screening

ObjectiveCancer screening should be equitably accessed by all populations. Uptake of colorectal cancer screening was examined using the Scottish Health and Ethnicity Linkage Study that links the Scottish Census 2001 to health data by individual-level self-reported ethnicity and religion.SettingData on 1.7 million individuals in two rounds of the Scottish Bowel Cancer Screening Programme (2007–2013) were linked to the 2001 Census using the Scottish Community Health Index number.Main outcome measureUptake of colorectal cancer screening, reported as age-adjusted risk ratios (RRs) by ethnic group and religion were calculated for men and women with 95% CI.ResultsIn the first, incidence screening round, compared with white Scottish men, Other White British (RR 109.6, 95% CI 108.8 to 110.3) and Chinese (107.2, 95% CI 102.8 to 111.8) men had higher uptake. In contrast, men of all South Asian groups had lower uptake (Indian RR 80.5, 95% CI 76.1 to 85.1; Pakistani RR 65.9, 95% CI 62.7 to 69.3; Bangladeshi RR 76.6, 95% CI 63.9 to 91.9; Other South Asian RR 88.6, 95% CI 81.8 to 96.1). Comparable patterns were seen among women in all ethnic groups, for example, Pakistani (RR 55.5, 95% CI 52.5 to 58.8). Variation in uptake was also observed by religion, with lower rates among Hindu (RR (95%CI): 78.4 (71.8 to 85.6)), Muslim (69.5 (66.7 to 72.3)) and Sikh (73.4 (67.1 to 80.3)) men compared with the reference population (Church of Scotland), with similar variation among women: lower rates were also seen among those who reported being Jewish, Roman Catholic or with no religion.ConclusionsThere are important variations in uptake of bowel cancer screening by ethnic group and religion in Scotland, for both sexes, that require further research and targeted interventions.

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Real-world cost-effectiveness of stool-based colorectal cancer screening in a Medicare population

Journal of Medical Economics ◽

10.1080/13696998.2021.1922240 ◽

2021 ◽

pp. 1-1

Author(s):

Deborah A. Fisher ◽

Jordan J. Karlitz ◽

Sushanth Jeyakumar ◽

Nathaniel Smith ◽

Paul Limburg ◽

...

Keyword(s):

Colorectal Cancer ◽

Cost Effectiveness ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Real World ◽

Medicare Population

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Mitigating the impact of COVID-19 on colorectal cancer screening: Organized service screening perspectives from the Asia-Pacific region

Preventive Medicine ◽

10.1016/j.ypmed.2021.106622 ◽

2021 ◽

pp. 106622

Author(s):

Han-Mo Chiu ◽

Chiu-Wen Su ◽

Weng-Feng Hsu ◽

Grace Hsiao-Hsuan Jen ◽

Chen-Yang Hsu ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Asia Pacific ◽

Pacific Region ◽

Asia Pacific Region ◽

The Impact

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Effects of cancer screening restart strategies after COVID-19 disruption

British Journal of Cancer ◽

10.1038/s41416-021-01261-9 ◽

2021 ◽

Vol 124 (9) ◽

pp. 1516-1523

Author(s):

Lindy M. Kregting ◽

Sylvia Kaljouw ◽

Lucie de Jonge ◽

Erik E. L. Jansen ◽

Elleke F. P. Peterse ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Catching Up ◽

Incidence And Mortality ◽

Specific Mortality ◽

Cancer Specific Mortality ◽

Catch Up ◽

Microsimulation Models ◽

The Impact

Abstract Background Many breast, cervical, and colorectal cancer screening programmes were disrupted due to the COVID-19 pandemic. This study aimed to estimate the effects of five restart strategies after the disruption on required screening capacity and cancer burden. Methods Microsimulation models simulated five restart strategies for breast, cervical, and colorectal cancer screening. The models estimated required screening capacity, cancer incidence, and cancer-specific mortality after a disruption of 6 months. The restart strategies varied in whether screens were caught up or not and, if so, immediately or delayed, and whether the upper age limit was increased. Results The disruption in screening programmes without catch-up of missed screens led to an increase of 2.0, 0.3, and 2.5 cancer deaths per 100 000 individuals in 10 years in breast, cervical, and colorectal cancer, respectively. Immediately catching-up missed screens minimised the impact of the disruption but required a surge in screening capacity. Delaying screening, but still offering all screening rounds gave the best balance between required capacity, incidence, and mortality. Conclusions Strategies with the smallest loss in health effects were also the most burdensome for the screening organisations. Which strategy is preferred depends on the organisation and available capacity in a country.

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