Faecal immunochemical test-based colorectal cancer screening programme SVIT in Slovenia

Abstract

Colorectal cancer (CRC) is the second most common cancer in Slovenia. The 5-year survival of patients depends on the clinical stage at presentation. More than 70% of patients with CRC are diagnosed as being in stage III or IV, with a 5-year survival rate of 52.7%. To improve the detection rate of CRC and to detect CRC in its early and more curable stage, a national screening programme is needed. In the year 2008, we started a pilot phase of the National CRC screening programme. We invited 9091 Slovene residents aged 64-68 years from Ljubljana, Kranj, and Celje regions, of whom 3807 responded to our invitation (41.9%). Two kits of the faecal immune test were sent to 3117 participants who met the inclusion criteria, and 2829 (90.7%) tests were returned. The compliance rate in our pilot programme was 32.9%. Among the patients who responded positively, 7.5% were positive. Until February 2009, 193 colonoscopies had been performed at DC Bled, DC Lipa and AM DC Rogaška. Intubation to the caecum was carried out in 99.4% of colonoscopies. Histology specimens were taken from 135 patients (70%). The adenoma detection rate was 53.8% (59.8% for men and 47.9% for women; P<0.05). We detected 1-17 adenomas per patient (2.4 on average). Advanced adenomas were detected in 60 patients (31%; 35.1% of men and 27.1% of women; P<0.05). Invasive carcinoma was detected in 15 patients (7.7%; 12.4% of men and 3.1% of women; P<0.05). Ten of them (73.3%) were in clinical stage I or II. In the pilot phase of the CRC screening programme the majority of CRCs were detected at early clinical stages. Invasive cancers were detected in 7.7% of patients. In almost all patients adenomas were resected at screening colonoscopy, thus reducing the possibility of later development of CRC in those patients.

A comparison of colorectal cancer in Nigerian and North American patients: Is the cancer biology different?

“…In a Slovenian study on screening with FOBT, 7.5% of screened patients had a positive test and 7.7% of these patients were diagnosed with invasive carcinoma – most of which were detected as stage I or II disease. 21 In West Africa, FOBT may similarly prove to be a useful initial screening test.…”

Quality Control in the Slovenian National Colorectal Cancer Screening Program

“…Overall, 30.591 (69%) individuals returned the post-colonoscopy questionnaire 1 month after colonoscopy was performed. The assessment of pain was done using a visual analogue scale: mild (0-3), moderate [4][5][6], and severe [7][8][9] no or mild pain (p = 0.03) and no significant differences in the pain scores between the cycles for the group with moderate pain (p = 0.47) and that with severe pain (p = 0.052).…”

“…National colorectal cancer screening in Slovenia (SVIT) started in 2009 [5,6]. The primary screening test in our NCCSP is a biennial faecal immunochemical test (FIT; [7,8]).…”

Delivering colorectal cancer screening integrated with primary health care services in Morocco: Lessons learned from a demonstration project

“…Lesion DRs were higher in men than in women, and similar findings were reported in other contexts. 20,23,25 The difficulties in reaching the male population and the lower compliance to colposcopy observed among men would be some of the challenges to be overcome by a scaled-up program.…”