Predicting the effectiveness of the Finnish population-based colorectal cancer screening programme

2017 ◽  
Vol 24 (4) ◽  
pp. 182-188 ◽  
Author(s):  
Sherry Yueh-Hsia Chiu ◽  
Nea Malila ◽  
Amy Ming-Fang Yen ◽  
Sam Li-Sheng Chen ◽  
Jean Ching-Yuan Fann ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Natural History ◽  
Screening Programme ◽  
Relative Rate ◽  
Occult Blood ◽  
Population Based ◽  
Finnish Population ◽  
Crc Screening ◽  
Natural History Model

Objective Because colorectal cancer (CRC) has a long natural history, estimating the effectiveness of CRC screening programmes requires long-term follow-up. As an alternative, we here demonstrate the use of a temporal multi-state natural history model to predict the effectiveness of CRC screening. Methods In the Finnish population-based biennial CRC screening programme using faecal occult blood tests (FOBT), which was conducted in a randomised health services study, we estimated the pre-clinical incidence, the mean sojourn time (MST), and the sensitivity of FOBT using a Markov model to analyse data from 2004 to 2007. These estimates were applied to predict, through simulation, the effects of five rounds of screening on the relative rate of reducing advanced CRC with 6 years of follow-up, and on the reduction in mortality with 10 years of follow-up, in a cohort of 500,000 subjects aged 60 to 69. Results For localised and non-localised CRC, respectively, the MST was 2.06 and 1.36 years and the sensitivity estimates were 65.12% and 73.70%. The predicted relative risk of non-localised CRC and death from CRC in the screened compared with the control population was 0.86 (95% CI: 0.79–0.98) and 0.91 (95% CI: 0.85–1.02), respectively. Conclusion Based on the preliminary results of the Finnish CRC screening programme, our model predicted a 9% reduction in CRC mortality and a 14% reduction in advanced CRC.

Initial participation as a predictor for continuous participation in population-based colorectal cancer screening

2017 ◽  
Vol 25 (3) ◽  
pp. 126-133 ◽  
Author(s):  
Deborah Saraste ◽  
Daniel J Öhman ◽  
Marika Sventelius ◽  
K Miriam Elfström ◽  
Johannes Blom ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Strong Predictor ◽  
Participation Rate ◽  
Occult Blood ◽  
Population Based ◽  
Faecal Occult Blood Testing ◽  
Faecal Occult

Objectives To assess patterns and probabilities of participation in multiple rounds of colorectal cancer screening. Methods All individuals who were invited to participate in population-based colorectal cancer screening in the Stockholm-Gotland region in Sweden between 1 January 2008 and 30 September 2015 were included in the study. Guaiac-based faecal occult blood testing was used. All individuals invited to the three first consecutive screening rounds were included in the analysis. Results There were 346,168 individuals eligible for invitation to screening. The average participation rate during the follow-up period was 60%. Eligible individuals could be invited 1–4 times, depending on age at first invitation. Of 48,959 individuals invited to the three first consecutive rounds of screening, 71% participated at least once, and 50% participated in all three rounds. Participation at first invitation was a predictor for participation in subsequent rounds, and the likelihood of continuous participation following participation in the first round was 84%. Of those who attended the first and second rounds, 93% also participated in the third round. Similar patterns of consistency were seen among non-participants. For individuals not participating in the first screening round, the likelihood of consistent non-participation was 71. Conclusions Participation in the first round of screening is a strong predictor for participation in subsequent rounds. Therefore, reducing barriers for initial participation is a key for achieving consistent participation over several rounds in organized colorectal cancer screening programmes.

scholarly journals Cost Analysis in a Population Based Screening Programme for Colorectal Cancer: Comparison of Immunochemical and Guaiac Faecal Occult Blood Testing

1997 ◽  
Vol 4 (3) ◽  
pp. 142-146 ◽  
Author(s):  
G Castiglione ◽  
M Zappa ◽  
G Grazzini ◽  
C Sani ◽  
A Mazzotta ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Programme ◽  
Cost Effective ◽  
Occult Blood ◽  
Recall Rate ◽  
Population Based ◽  
Faecal Occult Blood Testing ◽  
Faecal Occult Blood ◽  
Blood Tests ◽  
Faecal Occult

Objective— To compare the costs of colorectal cancer (CRC) screening by two faecal occult blood tests (FOBT)—namely, Hemoccult (guaiac based) and reversed passive haemagglutination (RPHA) tests. RPHA was interpreted according to two positivity thresholds (+ or +/-). Methods— Attenders performed both tests. Subjects with a positive FOBT test were invited to have a complete exploration of the colon. The total costs for every 10 000 screened subjects and costs for each unit of result (screened subject, or patient with adenoma/s or cancer detected) were calculated for both tests. Results— 8353 subjects were enrolled. A total of 2109 repeated screening after two years. RPHA(+ and +/-) showed the highest and RPHA(+) the lowest positivity rate at first screening. The Hemoccult positivity rate was highest at repeat screening. Total costs of screening by RPHA(+ and +/-) were highest as this method had the highest recall rate. Screening by RPHA(+) was the least costly. Costs for each screened subject were highest for RPHA(+ and +/-) and lowest for RPHA(+). Costs for each cancer detected were lowest for RPHA(+) and highest for Hemoccult or RPHA(+ and +/-) in subjects aged > 49 or < 50, respectively. Costs for subjects with detected adenoma/s of > 9 mm were lowest for RPHA(+ and +/-) and highest for Hemoccult. At repeat screening total costs of RPHA(+ and +/-) were lower than at first screening, whereas for each subject with cancer or adenoma/s costs were increased. Conclusions— Our data confirm that screening by RPHA is more cost effective than by Hemoccult.

scholarly journals Development and Validation of Three Regional Microsimulation Models for Predicting Colorectal Cancer Screening Benefits in Europe

2021 ◽  
Vol 6 (1) ◽  
pp. 238146832098497
Author(s):  
Andrea Gini ◽  
Maaike Buskermolen ◽  
Carlo Senore ◽  
Ahti Anttila ◽  
Dominika Novak Mlakar ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Occult Blood ◽  
Population Based ◽  
Incidence Rates ◽  
Fecal Occult Blood ◽  
Evaluation Tool ◽  
Additional Tool ◽  
Crc Screening ◽  
Published Evidence ◽  
Microsimulation Models

Background. Validated microsimulation models have been shown to be useful tools in providing support for colorectal cancer (CRC) screening decisions. Aiming to assist European countries in reducing CRC mortality, we developed and validated three regional models for evaluating CRC screening in Europe. Methods. Microsimulation Screening Analysis–Colon (MISCAN-Colon) model versions for Italy, Slovenia, and Finland were quantified using data from different national institutions. These models were validated against the best available evidence for the effectiveness of screening from their region (when available): the Screening for COlon REctum (SCORE) trial and the Florentine fecal immunochemical test (FIT) screening study for Italy; the Norwegian Colorectal Cancer Prevention (NORCCAP) trial and the guaiac fecal occult blood test (gFOBT) Finnish population-based study for Finland. When published evidence was not available (Slovenia), the model was validated using cancer registry data. Results. Our three models reproduced age-specific CRC incidence rates and stage distributions in the prescreening period. Moreover, the Italian and Finnish models replicated CRC mortality reductions (reasonably) well against the best available evidence. CRC mortality reductions were predicted slightly larger than those observed (except for the Florentine FIT study), but consistently within the corresponding 95% confidence intervals. Conclusions. Our findings corroborate the MISCAN-Colon reliability in supporting decision making on CRC screening. Furthermore, our study provides the model structure for an additional tool (EU-TOPIA CRC evaluation tool: http://miscan.eu-topia.org ) that aims to help policymakers and researchers monitoring or improving CRC screening in Europe.

SCREENING FOR COLORECTAL CANCER USING THE FECAL OCCULT BLOOD TEST: AN ACTUARIAL ASSESSMENT OF THE IMPACT OF A POPULATION-BASED SCREENING PROGRAM IN CANADA

2003 ◽  
Vol 19 (4) ◽  
pp. 715-723 ◽  
Author(s):  
Paul J. Villeneuve ◽  
Ann Coombs
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Occult Blood ◽  
Population Based ◽  
Fecal Occult Blood ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Fecal Occult ◽  
The Impact

Objectives:A series of randomized controlled trials have demonstrated that screening for colorectal cancer (CRC) using the fecal occult blood (FOB) test can decrease mortality from this disease. These findings were used to develop an actuarial model to estimate the impact that a FOB screening program for colorectal cancer would have on the Canadian population.Methods:The mortality experience of the year 2000 cohort of Canadians fifty to seventy-four years of age, with follow-up extending to 2010, was modelled according to three scenarios: no screening, annual screening, biennial screening. The primary screening tool was the FOB test using unrehydrated samples, with follow-up of positive test results using colonoscopy. The framework of the model was developed based on published findings from the relevant randomized controlled trials, available data, and a literature review that yielded parameter values for some model items.Results:During the 10-year follow-up of the cohort, we estimated that 4,444 and 2,827 deaths would be averted with annual and biennial FOB screening, respectively. We estimated that for an annual FOB screening program, approximately 3,400 FOB tests would be required to prevent one death, whereas 2,700 tests would be required within a biennial program.Conclusions:Our analysis documents the population health impact of using the FOB test to screen for CRC. Additional information on the natural history of the disease, and Canadian pilot data are needed to better model the effectiveness of population-based FOB screening programs.

scholarly journals Immunochemical vs guaiac faecal occult blood tests in a population-based screening programme for colorectal cancer

1996 ◽  
Vol 74 (1) ◽  
pp. 141-144 ◽  
Author(s):  
G Castiglione ◽  
M Zappa ◽  
G Grazzini ◽  
A Mazzotta ◽  
M Biagini ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Programme ◽  
Occult Blood ◽  
Population Based ◽  
Faecal Occult Blood ◽  
Blood Tests ◽  
Faecal Occult

scholarly journals A Survey of Provider Attitudes, Beliefs, and Perceived Barriers Regarding a Centralized Direct-Mail Colorectal Cancer Screening Approach at Community Health Centers

2019 ◽  
Vol 10 ◽  
pp. 215013271989095
Author(s):  
Jamie H. Thompson ◽  
Jennifer L. Schneider ◽  
Jennifer S. Rivelli ◽  
Amanda F. Petrik ◽  
William M. Vollmer ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Population Based ◽  
Direct Mail ◽  
Provider Attitudes ◽  
Beliefs And Practices ◽  
Screening Programs ◽  
Crc Screening

Background: Colorectal cancer screening (CRC) rates are low, particularly among individuals with low socioeconomic status. Organized CRC screening programs have demonstrated success in increasing screening rates. Little is known about provider attitudes, beliefs, and practices related to CRC screening or how they are influenced by an organized CRC screening program. Methods: In 2014 and 2016, providers from 26 safety net clinics in Oregon and Northern California were invited to complete baseline and follow-up online surveys for the Strategies and Opportunities to Stop Colon Cancer in Priority Populations (STOP CRC) study. The provider survey link was sent electronically to primary care providers serving adult patients. Providers were sent reminders every 2 weeks via email to complete the survey, up to 3 reminders total. In this article, we describe learnings about provider attitudes, beliefs, and practices related to CRC screening after implementation of the STOP CRC program. Results: A total of 166 unique providers completed baseline and/or follow-up surveys, representing 228 responses. Main themes included (1) favorable shifts in attitude toward fecal immunochemical test (FIT) and direct-mail cancer screening programs, (2) changes in provider perception of key barriers, and (3) growing interest in centralized automated systems for identifying patients due for CRC screening and eligible for population-based outreach. Discussion: Providers are interested in improved information systems for identifying patients due for CRC screening and delivering population-based outreach (ie, to distribute FIT kits outside of the clinic visit) to help reduce health system- and patient-level barriers to screening. Trial Registration: National Clinical Trial (NCT) Identifier NCT01742065.

scholarly journals Low rate of follow-up colonoscopy after positive results of colorectal cancer screening in a Chinese urban core district

2019 ◽  
Author(s):  
Yawen Guo ◽  
Qingwu Jiang ◽  
Tetsuya Tanimoto ◽  
Masahiro Kami ◽  
Peng Peng ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rural Areas ◽  
Municipal Government ◽  
Precancerous Lesions ◽  
Population Based ◽  
Registry Data ◽  
Crc Screening ◽  
Incidence And Mortality ◽  
The Status

AbstractColorectal cancer (CRC) is one of the most common cancers in China. In 2003, a systematic CRC registry that enables the determination of CRC incidence and mortality and a CRC screening project were introduced in the Jing’an district of Shanghai by the municipal government. This study assessed the registry data to determine the status of CRC and CRC screening rates in the core district of an urban area of China. Data were retrieved from the Official registry information systems of Jing’an district Shanghai Cance. The incidence and mortality of CRC, as well as population-based CRC screening rates, were analysed. Individuals who screened positive for CRC based upon results of a high-risk factor questionnaire (HRFQ) and a faecal immunochemical test (FIT) were selected for follow-up colonoscopy (CSPY). From the registry data collected between 2003 and 2013, the standardized incidence rate was 26.44/105, with a significant gender difference. The CRC standardized mortality rate was 10.08/105. In 2013, 17,866 individuals (21.6%) enrolled for CRC screening among the 82,602 candidate residents. The positive screening rate was 16.28% (2909/17866). Among the 2909 positives, 508 (17.5%) underwent follow-up CSPY. In 41.3% of these individuals (210/508), abnormal lesions were detected. Of these, 8 (1.57%) lesions were diagnosed as CRC, and 142 (28.0%) were identified as precancerous lesions. During the assessment period, both the incidence and mortality of CRC in the Jing’an district were determined in the area of high CRC prevalence in Chin. Nevertheless, the rate of participation in CRC screening was low (21.6%), and the rate of participation in follow-up CSPY for individuals who screened positive was only 17.5%. Improved participation in CRC screening and follow-up CSPY is expected to lower the incidence and mortality of CRC significantly in the rural areas of China. (288)

scholarly journals Does the Flemish colorectal cancer screening programme reach equity in FIT uptake?

2019 ◽  
Vol 29 (6) ◽  
pp. 1108-1114
Author(s):  
S Hoeck ◽  
W van de Veerdonk ◽  
I De Brabander ◽  
E Kellen
Keyword(s):  
Colorectal Cancer ◽  
Minimum Wage ◽  
Screening Programme ◽  
Economic Status ◽  
Descriptive Analysis ◽  
Population Based ◽  
Crc Screening ◽  
Screening Uptake ◽  
Study Results ◽  
Significant Difference

Abstract Background To investigate colorectal cancer (CRC) screening rates by the faecal immunochemical test (FIT) according to sociodemographic characteristics and nationality. Methods Men and women, aged 56–74, invited to participate in the Flemish CRC screening programme in 2013 and 2014 were included in this study. We analysed the association between CRC screening uptake and sex, age, (first and current) nationality and several proxies for socio-economic status (SES). The statistical analysis was based on descriptive analyses and logistic regression models. Results A total of 1 184 426 persons were included in our analysis. The overall screening uptake was 52.3%, uptake varied by sex, age, nationality and SES. Lower participation rates were associated with the youngest and oldest age categories (56–60 and 70–74) and being male. All nationalities other than Belgian or Dutch were significantly less screened. Lower uptake of screening was also associated with several proxy’s for low SES, such as having an allowance for being disabled, not being able to work, being an extended minor and having a social allowance/minimum wage. The descriptive analysis showed a 27% difference in CRC screening uptake between the (early) retired and the people entitled to a minimum wage. Conclusions There is a significant difference between screening uptake and demographic and socio-economic variables in the first 2 years of the population-based screening programme in Flanders. Based on the study results, implementing strategies to improve participation in those subgroups is needed.

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