Mariann RUTKA,
Renata BOR,
Tamas MOLNAR,
Klaudia FARKAS,
Daniella PIGNICZKI,
Anna FABIAN,
Mark GYŐRFFY,
Anita BALINT,
Agnes MILASSIN,
Ferenc NAGY,
Zoltan SZEPES,
Monika SZÜCS,
Laszlo TISZLAVICZ
3523
Efficacy of the population-based pilot colorectal cancer screening, Csongrád county, Hungary, 2015
Efficacy of the population-based pilot colorectal cancer screening, Csongrád county, Hungary, 2015
Background/aim: In Hungary, a nationwide colorectal screening program is about to be introduced in order to improve the highmortality rate of colorectal cancer (CRC). The aim was to summarize experiences from and assess short-term efficacy of the populationbased pilot colorectal screening program in 2015 in Csongrád county, Hungary.Materials and methods: Asymptomatic individuals between the ages of 50 and 70 with average risk of colorectal cancer participated inthe program that was based on the two-step screening method: immune fecal blood test and colonoscopy. The short-term efficacy wasassessed as the change in total CRC incidence and initial tumor stage in the screening year (2015).Results: 22,130 individuals were invited to participate, and the participation rate was 46.4%. Immune fecal blood test proved to benonnegative in 1,343 cases (13%), screening colonoscopy was performed in 766 of them (7.5%). Total colonoscopy was performed in711 individuals. Based on the reports, adenoma was detected in 358 (50.3%) and malignancy in 42 (5.9%) individuals. In the backgroundpopulation, the incidence of colon cancer was higher (183 vs. 228; P = 0.026) and was diagnosed at earlier stage (P = 0.002), while lymphnode involvement was lower in 2015 (48.3% vs. 37.1%; P = 0.049).Conclusion: The Csongrád county population-based colorectal cancer screening was evidently successful on the short-term consideringparticipation rate, and the changes in CRC incidence and stage, thus its national extension is necessary.
___
- 1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International Journal Cancer 2015;136: E359–E386. doi: 10.1002/ijc.29210
- 2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. European Journal of Cancer 2013; 49:1374-1403. doi: 10.1016/j.ejca.2012.12.027
- 3. Altobelli E, Lattanzi A, Paduano R, Varassi G, Di Orio F et al. Colorectal cancer prevention in Europe: burden of disease and status of screening programs. Preventive Medicine 2014; 62: 132-141. doi: 10.1016/j.ypmed.2014.02.010
- 4. Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F et al. Global Burden of Disease Cancer Collaboration (International Agency for Research on Cancer: World Cancer Report). Geneva, Switzerland: World Health Organization; 2014. doi: 10.1001/jamaoncol.2019.2996
- 5. Benson VS, Patnick J, Davies AK, Nadel MR, Smith RA et al. International Colorectal Screening Network. Colorectal cancer screening: a comparison of 35 initiatives in 17 countries. International Journal of Cancer 2008; 122:1357-1367. doi: 10.1002/ijc.23273
- 6. Council of the European Union. Council recommendation of 2 December 2003 on cancer screening (2003/878/EC). Official Journal of European Union 2003; L327: 34-38.
- 7. Emberi Erőforrások Minisztériuma. Egészséges Nemzetért Népegészségügyi Program 2001–2010. Egészségügyi Közlöny, 2001/16. szám. 2001. augusztus 21 (in Hungarian).
- 8. Hari DM, Leung AM, Lee JH, Sim MS, Vuong B et al. AJCC Cancer Staging Manual 7th edition criteria for colon cancer: do the complex modifications improve prognostic assessment? Journal of the American College of Surgeons 2013; 217 (2): 181-190. doi: 10.1016/j.jamcollsurg.2013.04.018. Epub 2013 Jun 12.
- 9. ÁNTSZ Állami Népegészségügyi és Tisztiorvosi Szolgálat honlap: Vastagbélszűrési alprojekt bemutatása, eredményei (in Hungarian).
- 10. Pignone M, Saha S, Hoerger T, Mandelblatt J. Cost-effectiveness analyses of colorectal cancer screening: a systematic review for the U.S. Preventive Services Task Force. Annals of Internal Medicine 2002; 137: 96-104. doi: 10.7326/0003-4819-137-2- 200207160-00007
- 11. Központi Statisztikai Hivatal. Surveillance, Epidemiology, and End Results (SEER) Program. 2015.
- 12. Howlader N, Noone AM, Krapcho M, Miller D, Bishop K et al. SEER Cancer Statistics Review, 1975–2013. National Cancer Institute, Bethesda, MD. November 2015.
- 13. Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester RGS et al. Colorectal cancer statistics, 2017. CA: Cancer Journal for Clinicians 2017; 67 (3): 177-193. doi: 10.3322/caac.21395
- 14. Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS et al. Prevention of colorectal cancer by colonoscopic polypectomy. The New England Journal of Medicine 1993; 329: 1977-1981. doi: 10.1056/NEJM199312303292701
- 15. Shroff J, Thosani N, Batra S, Singh H, Guha S. Reduced incidence and mortality from colorectal cancer with flexiblesigmoidoscopy screening: a meta-analysis. World Journal of Gastroenterology 2014; 20: 18466-18476. doi: 10.3748/wjg.v20. i48.18466
- 16. Brenner H, Stock C, Hoffmeister M. Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and metaanalysis of randomised controlled trials and observational studies. BMJ 2014; 348: g2467. doi: 10.1136/bmj.g2467
- 17. Robertson DJ, Lee JK, Boland CR, Dominitz JA, Giardiello FM et al. Recommendations on fecal immunochemical testing to screen for colorectal neoplasia: a consensus statement by the US multi-society task force on colorectal cancer. Gastroenterology 2017; 152: 1217-1237.e3. doi: 10.1053/j.gastro.2016.08.053
- 18. Rembacken B, Hassan C, Riemann JF, Chilton A, Rutter M et al. Quality in screening colonoscopy: position statement of the European Society of Gastrointestinal Endoscopy (ESGE). Endoscopy 2012; 44: 957-968. doi: 10.1055/s-0032-1325686
- 19. Navarro M, Nicolas A, Ferrandez A, Lanas A. Colorectal cancer population screening programs worldwide in 2016: An update. World Journal of Gastroenterology 2017; 23: 3632-3642. doi: 10.3748/wjg.v23.i20.3632
- 20. Zauber A G, Winawer S J, O’Brien M J, Lansdorp-Vogelaar I, Ballegooijen M et al. Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. New England Journal of Medicine 2012; 366: 687-696. doi: 10.1056/NEJMoa1100370