Colorectal cancer population screening programs worldwide in 2016: An update

Abstract

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in the world. The incidence and mortality show wide geographical variations. Screening is recommended to reduce both incidence and mortality. However, there are significant differences among studies in implementation strategies and detection. This review aimed to present the results and strategies of different screening programs worldwide. We reviewed the literature on national and international screening programs published in PubMed, on web pages, and in clinical guidelines. CRC Screening programs are currently underway in most European countries, Canada, specific regions in North and South America, Asia, and Oceania. The most extensive screening strategies were based on fecal occult blood testing, and more recently, the fecal immunochemical test (FIT). Participation in screening has varied greatly among different programs. The Netherlands showed the highest participation rate (68.2%) and some areas of Canada showed the lowest (16%). Participation rates were highest among women and in programs that used the FIT test. Men exhibited the greatest number of positive results. The FIT test has been the most widely used screening program worldwide. The advent of this test has increased participation rates and the detection of positive results. Core tip: Colorectal cancer is the third most commonly diagnosed cancer worldwide. The incidence and mortality show wide geographical variations across the world. Screening is recommended to reduce both, however, there are significant differences among studies in implementation strategies and detection. This review aimed to present the results and strategies of different screening programs worldwide.

Colonoscopy Findings in Patients Who Have Positive Fecal Occult Blood Test for Colorectal Cancer Screening

“…Bu oran Fransa'da %88, İngiltere'de %83, İrlanda'da %83, Hollanda'da %74,3, Hırvatistan'da %66, Litvanya'da %66,1'dir. 16 Tarama programının daha etkin olması, daha fazla kanserin erken evrede yakalanması amacıyla kolonoskopi yaptırma oranının yükseltilmesi gerekmektedir. Bunun için kolonoskopi için yönlendirileren hastalara, kanser riski, kolonoskopinin kesinlikle yapılması gerektiği ve bunun önemi hakkında ayrıntılı olarak bilgi verilmelidir.…”

“…KRK tarama programlarını değerlendiren bir derlemede, Güney Kore'de GGK pozitifliği saptanan hastalarda kolonoskopi yapılma oranının %31,4 ve kanser saptanma oranının %1,2 olduğu bildirilmiş ve düşük kolonoskopi yapılma oranının düşük kanser saptanma oranıyla ilgili olabileceği ifade edilmiştir. 16 Bu sonuç, kolonoskopi yapılma oranın arttırılmasının önemini göstermektedir. Çalışmamızda GGK pozitifliği yapabilen maligniteyle ilgili olmayan diğer patolojileri incediğimizde, hastaların yaklaşık %50'sinde kolonik divertikül ve hemoroid ve anal fissür gibi anal bölge patolojileri saptanmıştır.…”

Should colonoscopy screening be performed in patients with adnexal mass?

“…CRC screening programs are being implemented in many European countries, Canada, America, and Asia. Occult blood in stool (OBS) and recently applied fecal immunohistochemical test (FIT) are the most common screening methods (12)(13)(14).…”

Early detection and therapeutics

“…Endoscopy with biopsies remain the gold standard for the diagnosis of GI malignancies; however, its utility as a screening modality is limited to colorectal cancer (CRC). In 2015, 24 out of 28 countries in the European Union had established or upcoming country‐wide CRC screening programmes targeting the average‐risk population, defined as individuals aged 50 years or older with no additional risk factors (Navarro et al ., ). Despite the well‐defined target population, there is a wide variation in screening practices among those countries resulting from different financial resources and healthcare system capacities.…”