Colorectal Cancer Screening Programme in Spain: Results of Key Performance Indicators After Five Rounds (2000–2012)

Abstract

Effective quality assurance is essential in any screening programme. This article provides a unique insight into key quality indicators of five rounds of the first population-based colorectal cancer screening programme implemented in Spain (2000–2012), providing the results according to the type of screening (prevalent or first screen and incident or subsequent screen) and test (guaiac or immunochemical). The total crude participation rate increased from 17.2% (11,011) in the first round to 35.9% (22,988) in the last one. Rescreening rate was very high (88.6% in the fifth round). Positivity rate was superior with the faecal immunochemical test (6.2%) than with the guaiac-based test (0.7%) (p < 0.0001) and detection rates were also better with the immunochemical test. The most significant rise in detection rate was observed for high risk adenoma in men (45.5 per 1,000 screened). Most cancers were diagnosed at an early stage (61.4%) and there was a statistically significant difference between those detected in first or subsequent screening (52.6% and 70.0% respectively; p = 0.024). The availability of these results substantially improves data comparisons and the exchange of experience between screening programmes.

Scottish Bowel Screening Programme colonoscopy quality – scope for improvement?

“…In addition, the publication on colonoscopy quality measures within the NHS BCSP argued against, and omitted, the CDR as a quality measure. The data on trends of cancer detection as part of a national programme demonstrate lower CDR in subsequent incident rounds compared with the prevalent round [20], consistent with other bowel screening programmes [20,21]. As such, the CDR represents a poor marker of screening colonoscopy quality and reflects cancer incidence more [11,22].…”

Gut microbiome diversity detected by high-coverage 16S and shotgun sequencing of paired stool and colon sample

“…Patients with a positive test result (≥20 g Hb/g faeces) are referred for colonoscopy examination. A detailed description of the screening program is provided elsewhere 28,29 . Exclusion criteria are as follows: gastrointestinal symptoms; family history of hereditary or familial colorectal cancer (2 first-degree relatives with CRC or 1 in whom the disease was diagnosed before the age of 60 years); personal history of CRC, adenomas or inflammatory bowel disease; colonoscopy in the previous five years or a FIT within the last two years; terminal disease; and severe disabling conditions.…”

Gut microbiome diversity detected by high-coverage 16S and shotgun sequencing of matched stool and colon biopsy samples

“…Patients with a positive test result ( 20 g Hb/g faeces) are referred for colonoscopy examination. A detailed description of the screening program is provided elsewhere [28,29]. Exclusion criteria are as follows: gastrointestinal symptoms; family history of hereditary or familial colorectal cancer (2 first-degree relatives with CRC or 1 in whom the disease was diagnosed before the age of 60 years); personal history of CRC, adenomas or inflammatory bowel disease; colonoscopy in the previous five years or a FOBT within the last two years; terminal disease; and severe disabling conditions.…”