The effect of deprivation on uptake and outcomes in a population-based FOBt colorectal cancer screening program.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3599-3599
Author(s):  
David Mansouri ◽  
Donald C. Mcmillan ◽  
Emilia M Crighton ◽  
Paul G Horgan

3599 Background: Population-based FOBt colorectal cancer screening has been shown to reduce cancer specific mortality and is used across the UK. Despite evidence that socioeconomic deprivation is associated with increased incidence of colorectal cancer, uptake of screening may be lower in those who are more deprived. The aim of this study was to assess the impact of deprivation on the screening process. Methods: A prospectively maintained database, encompassing the first screening round in a single geographical area, was analysed with deprivation categories calculated from the Scottish Index of Multiple Deprivation 2009. Results: Overall, 395,698 individuals were invited to screening, 204,812(52%) participated and 6,094(3%) tested positive. 32% of screened individuals were in the most deprived quintile. Of the positive tests, 5,457(95%) agreed to be pre-assessed for colonoscopy. 839(16%) did not proceed to colonoscopy following pre-assessment. Of the 4,618 that attended for colonoscopy, cancer was detected in 7%. Colonoscopy results were not recorded in 1,035(22%) cases. Lower uptake of screening was seen in males, those that were younger and those who were more deprived (p<0.001). Higher levels of deprivation were also associated with not proceeding to colonoscopy following pre-assessment (p<0.001). Higher positivity rates were seen in males, those that were older and more deprived (p<0.001). Despite higher positivity rates in the more deprived individuals (4% most deprived vs 2% least deprived, p<0.001), the positive predictive value of detecting cancer in those attending for colonoscopy was lower in those who were more deprived (6% most deprived vs 8% least deprived, p=0.040). Conclusions: Socioeconomic deprivation has a significant effect throughout the FOBt screening process. Individuals who are more deprived are less likely to participate in screening, less likely to complete the screening process and less likely to have cancer identified as a result of a positive test. This study adds further weight to existing evidence that individuals who are more deprived are less likely to engage in population-based FOBt colorectal cancer screening. Novel strategies to improve this are required.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 411-411
Author(s):  
Jérôme Viguier ◽  
Jean F. Morere ◽  
Xavier B. Pivot ◽  
Yvan Coscas ◽  
Jean-Yves Blay ◽  
...  

411 Background: In France, after a pilot population-based screening program (2002-2003), a national organized program targeting 17 million persons was progressively implemented starting in 2005 and generalized after 2009. The EDIFICE 3 survey was conducted in 2011, after EDIFICE 1 (2005) and EDIFICE 2 (2008), to provide a better understanding of the participation of the French population in the colorectal cancer screening program and to assess the evolution between the three periods. Methods: This third nationwide observational study, EDIFICE 3, was conducted through phone interviews among a representative sample of 1603 subjects aged between 40 and 75years, using the quota method. This analysis focused on the target population of the national screening program (50-74 years old). Results: In 2011, 59% of subjects between 50 and 74 years (N=946) declared having performed a screening test for colorectal cancer (including fecal test or colonoscopy) versus 38% in 2008 (p<0.05) and 25% in 2005 (p<0.05). Colorectal cancer screening increased significantly in all age groups, especially between 65 and 69 years, and for both sexes. Among the screened population, the recommended interval between two tests was respected in 51% of cases in EDIFICE 3. 62% of unscreened individuals plan to undergo a screening test in the near future. The main factors increasing the probability of screening were: being encouraged by one’s family, the existence of a case colorectal cancer in the family circle, higher frequency of medical consultation, better knowledge of the screening process and being reassured by the screening. The main reasons for not undergoing the screening were: not feeling concerned, fear of exams or results, no recommendation by the GP and carelessness. Conclusions: The European guideline objective rate of participation for colorectal cancer screening (65%) is not yet reached. This goal could be achieved by motivating the unscreened population already planning to perform a test. The trend for increasing testing will probably be confirmed in the future if the reasons for non-attendance in an organized program are addressed.


2017 ◽  
Vol 26 (9) ◽  
pp. 1401-1410 ◽  
Author(s):  
Tara Kiran ◽  
Richard H. Glazier ◽  
Rahim Moineddin ◽  
Sumei Gu ◽  
Andrew S. Wilton ◽  
...  

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1129
Author(s):  
Audrius Dulskas ◽  
Tomas Poskus ◽  
Inga Kildusiene ◽  
Ausvydas Patasius ◽  
Rokas Stulpinas ◽  
...  

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.


2021 ◽  
pp. 106420
Author(s):  
Nuria Vives ◽  
Núria Milà ◽  
Gemma Binefa ◽  
Noemie Travier ◽  
Albert Farre ◽  
...  

2016 ◽  
Vol 70 (5) ◽  
pp. 383-392 ◽  
Author(s):  
Tomáš Grega ◽  
Ondřej Májek ◽  
Ondřej Ngo ◽  
Norbert Král ◽  
Bohumil Seifert ◽  
...  

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 352-352
Author(s):  
Jérôme Viguier ◽  
Yvan Coscas ◽  
Chantal Touboul ◽  
Jean F. Morere ◽  
Jean-Yves Blay ◽  
...  

352 Background: In France, following a pilot population-based screening program in 2002-2003, a national organized program targeting 17 million people was progressively implemented from 2005 to 2009. EDIFICE surveys are iterative polls focusing on cancer screening behavior. The EDIFICE 3 survey was conducted in 2011 and partly dedicated to knowledge of the colorectal cancer screening process. Methods: This third nationwide observational study, EDIFICE 3, was conducted via phone interviews among a representative sample of 946 subjects aged between 50 and 74 years, who had never been treated for cancer. 59% of the population declared having undergone colorectal cancer screening (fecal test or colonoscopy). Results: Interviewed about the screening process, 510/946 (54%) of the French population were unaware of the procedure after a positive fecal test and 782/946 (83%) were unaware of how soon a new test should be performed after a negative result. Only 79/946 (8%) were aware of what to do after either a positive or a negative test and 47% in one out of the two cases. 84% of subjects over assessed (by a factor 2 to 10) the probability of having cancer after a positive test. In contrast, 65% were aware of the possibility of a false negative test. Only 3% of our sample know both the right screening agenda (every other year) and the need for a colonoscopy after a positive test. Neither gender, educational level and socio economic level significantly impacted the rate of right answers. Conclusions: This study demonstrates a lack of detailed knowledge on the colorectal cancer screening process in the French national program. This raises the issue of the fairness of the process (an ethical issue) and may be a reason for the current poor uptake (an effectiveness issue). This should be tackled by improving the transmission of information, preferentially via general practitioners, institutional letters sent directly to subjects (in our survey these two media were found to be readily accepted) and lay press.


Sign in / Sign up

Export Citation Format

Share Document