RT Journal Article
SR Electronic
T1 Performance of colorectal cancer screening in the European Union Member States: data from the second European screening report
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 1232
OP 1244
DO 10.1136/gutjnl-2018-317293
VO 68
IS 7
A1 Carlo Senore
A1 Partha Basu
A1 Ahti Anttila
A1 Antonio Ponti
A1 Mariano Tomatis
A1 Diama Bhadra Vale
A1 Gugliemo Ronco
A1 Isabelle Soerjomataram
A1 Maja Primic-Žakelj
A1 Emilia Riggi
A1 Joakim Dillner
A1 Miriam Klara Elfström
A1 Stefan Lönnberg
A1 Rengaswamy Sankaranarayanan
A1 Nereo Segnan
YR 2019
UL http://gut.bmj.com/content/68/7/1232.abstract
AB Objective To present comparative data about the performance of colorectal cancer (CRC) screening programmes in the European Union Member States (EU MSs).Design Cross-sectional study. We analysed key performance indicators—participation rate, positivity rate (PR), detection rate (DR) and positive predictive value for adenomas and CRC—based on the aggregated quantitative data collected for the second EU screening report. We derived crude and pooled (through a random effects model) estimates to describe and compare trends across different MSs/regions and screening protocols.Results Participation rate was higher in countries adopting faecal immunochemical test (FIT) (range: 22.8%–71.3%) than in those using guaiac faecal occult blood test (gFOBT) (range 4.5%–66.6%), and it showed a positive correlation (ρ=0.842, p<0.001) with participation in breast cancer screening in the same areas. Screening performance showed a large variability. Compliance with referral for colonoscopy (total colonoscopy (TC)) assessment ranged between 64% and 92%; TC completion rate ranged between 92% and 99%. PR and DR of advanced adenomas and CRC were higher in FIT, as compared with gFOBT programmes, and independent of the protocol among men, older subjects and those performing their first screening.Conclusions The variability in the results of quality indicators across population-based screening programmes highlights the importance of continuous monitoring, as well as the need to promote quality improvement efforts, as recommended in the EU guidelines. The implementation of monitoring systems, ensuring availability of data for the entire process, together with initiatives aimed to enhance reproducibility of histology and quality of endoscopy, represent a priority in screening programmes management.