Impact of a Population-Based Colorectal Cancer Screening Program on Local Health Services Demand in Italy: A 7-Year Survey in a Northern Province

Abstract

After the implementation of a FOBT-based mass-screening program for CRC, careful consideration must be given to the significant increase in the workload of hospital services involved in CRC diagnosis, outside the screening campaign. The extra-work mainly involves gastroenterologists performing colonoscopy, whose activity increased over the 5-year period by 118%, as well as laboratory services, where the demand of FOBTs rose by 40%. This phenomenon, mainly attributable to a profound change in the attitude toward CRC screening by those age cohorts outside the program, covers a time span of two full rounds of screening, whereupon a steady trend for colonoscopy is apparent.

Random comparison of repeated faecal immunochemical testing at different intervals for population-based colorectal cancer screening

“…Additionally, the majority of FIT-related data published so far have not been tabulated by screening round and therefore do not allow analysis of participation and diagnostic yield per screening round 31–35. One exception is an Italian study in which all individuals were invited for biennial 1-sample FIT screening 36. Our main results concerning second round participation and diagnostic yield are in line with these Italian results.…”

Strategies and Resources to Address Colorectal Cancer Screening Rates and Disparities in the United States and Globally

“…For example, the national screening program in Italy yielded dramatically different levels of screening among targeted individuals in different regions of the country; screening rates in 2007 ranged from 71.6% in the north region of the country and 52.1% in the central region to just 7% in the southern region (38). National programs may need to start with pilot testing to identify the best strategies to reach the entire population, and they may need to be retooled or redesigned when initial efforts either strain the existing infrastructure or are less successful than hoped (12,49). Some have expressed concern that programs with limited objectives, such as one-time or relatively infrequent stool testing with FOBT or FIT, may miss many cancers, especially among those who are at higherthan-average risk for colorectal cancer (59).…”

Fecal Occult Blood Test Results of the National Colorectal Cancer Screening Program in South Korea (2006–2013)

“…Researchers in many countries, including Scotland 4 , Germany 5 , United Kingdom 6 , France 7 , Italy 8 , Canada 9 , Croatia 10 , Spain 11 , and Finland 12 have published the results of national CRC screening by various screening strategies such as FOBT, colonoscopy, and sigmoidoscopy. Although few reports have studied the results of national CRC screening programs for Asian populations 13, 14 or the Korean population 15–17 , a relatively small size and short period have been limitations in comparison to reports from Western Caucasian populations.…”