Lessons learnt from a population-based pilot programme for colorectal cancer screening in Catalonia (Spain)

Peris, Mercé; Espinàs, Josep Alfons; Muñoz, Laura; Navarro, Matilde; Binefa, Gemma; Borrás, Josep María

doi:10.1258/096914107781261936

Cited by 76 publications

(60 citation statements)

References 49 publications

(47 reference statements)

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“…The experience of the cancer screening networks established under the European Partnership Action Against Cancer (EPAAC) demonstrated that piloting prior to nationwide rollout could provide the policymakers with information essential for effective programme implementation. [13][14][15] Furthermore, as described in the European quality assurance guidelines, a long term translational phase is essential to successfully plan, pilot and rollout population-based programmes across an entire country. The time frame depends, to a large extent, on the professional and organizational capacity, which must be developed to successfully perform, monitor and evaluate the high quality services.…”

Section: Discussionmentioning

confidence: 99%

Status of implementation and organization of cancer screening in The European Union Member States—Summary results from the second European screening report

Basu

Ponti

Anttila

et al. 2017

Intl Journal of Cancer

179

173

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The second report on the implementation status of cancer screening in European Union (EU) was published in 2017. The report described the implementation status, protocols and organization (updated till 2016) and invitation coverage (for index year 2013) of breast, cervical and colorectal cancer screening in the EU. Experts in screening programme monitoring (N 5 80) from the EU Member States having access to requisite information in their respective countries provided data on breast, cervical and colorectal cancer screening through online questionnaires. Data was collected for screening performed in the framework of publicly mandated programmes only. Filled in questionnaires were received from 26 Member States for all three sites and from one Member State for breast cancer only. Substantial improvement in screening implementation using populationbased approach was documented. Among the age-eligible women, 94.7% were residents of Member States implementing or planning population-based breast cancer screening in 2016, compared to 91.6% in 2007. The corresponding figures for cervical cancer screening were 72.3 and 51.3% in 2016 and 2007, respectively. Most significant improvement was documented for colorectal cancer screening with roll-out ongoing or completed in 17 Member States in 2016, compared to only five in 2007. So the access to population-based screening increased to 72.4% of the age-eligible populations in 2016 as opposed to only 42.6% in 2007. The invitation coverage was highly variable, ranging from 0.2-111% for breast cancer, 7.6-105% for cervical cancer and 1.8-127% for colorectal cancer in the target populations. In spite of the considerable progress, much work remains to be done to achieve optimal effectiveness. Continued monitoring, regular feedbacks and periodic reporting are needed to ensure the desired impacts of the programmes.

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Section: Discussionmentioning

confidence: 99%

Status of implementation and organization of cancer screening in The European Union Member States—Summary results from the second European screening report

Basu

Ponti

Anttila

et al. 2017

Intl Journal of Cancer

179

173

View full text Add to dashboard Cite

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“…In Italy and Spain, age and gender trends were similar. 23,24 In Italy and the UK, positive test rates were also higher in men than in women. One year or more after test results, not all colonoscopy results were recorded by the monitoring centre.…”

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confidence: 99%

“…17,23 In the Spanish pilot programme in Catalonia, this rate reached 86.6%. 24 In the districts where the percentage is high, specific strategies for data collection from doctors were in place (reminders, letters or mails to physicians, phone calls, and as a last resort, posting a registered mail to the person with a positive test). In the French pilot programme, among the 14% of those who did not undergo colonoscopy, some people refused colonoscopy.…”

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confidence: 99%

French colorectal cancer screening pilot programme: results of the first round

et al. 2008

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Objectives In France, a national pilot population-based screening programme on colorectal cancer was set up in French districts were included, targeting a population of more than five million people. This programme offers biennial screening using the fecal occult blood test (FOBT) to average risk subjects aged between 50 and 74 years. People receive a letter inviting them to consult their GPs, who in turn provide the FOBT. People with a positive test result are proposed a full colonoscopy. The results of the programme's first-round performance indicators are presented. Methods The monitoring centre collected data from GPs and gastroenterologists on follow-up and colonoscopy results for people who were screened positive. Data were transferred to the French Institute for Public Health Surveillance (InVS) for the analysis. Results The overall participation rate for the 19 districts having completed a first screening round reached 42%. The overall positive test rate was 2.7%. In the eight districts with comprehensive follow-up data for the first round, 86% of colonoscopies were completed after a positive test. A total of 1615 people were diagnosed with cancer, and 4612 people with adenoma. The cancer detection rate reached 2.3%, it was higher in men than in women (3.4% versus 1.4%), and increased with age. Forty-three percent of invasive detected cancers were stage I, 24% stage II, 23% had lymph node involvement and 10% presented with distant metastasis. Conclusion These results suggest that indicators are consistent with international references. During 2007 -2008, the programme coverage will be progressively extended, and all 99 French districts should be actively involved in its implementation.

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“…Los puntos críticos de nuestros resultados en cuanto a participación y tasa de detección han sido recientemente analizados (19).…”

Section: Discussionunclassified

“…El protocolo ha sido descrito en una publicación previa (19 Como prueba de cribado, se utilizó la determinación de sangre oculta en heces mediante el test guaiaco (TSOH), que consiste en recoger 2 muestras de heces de 3 deposiciones diferentes sin restricción dietética inicial. Si se detectaba la presencia de sangre en menos de 5 muestras (resultado débil positivo), se aconsejaba repetir el test con restricción dietética.…”

Section: Métodosunclassified

Hallazgos colonoscópicos del estudio piloto de cribado de cáncer colorrectal realizado en Cataluña

Navarro

Peris

Binefa

et al. 2008

Rev. esp. enferm. dig.

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RESUMEN Objetivo: evaluar las lesiones detectadas en las dos rondas ya finalizadas del Programa Piloto de Cribado en Cáncer Colorrectal (CCR) llevado a cabo en L'Hospitalet de Llobregat (Barcelona).Material y métodos: el programa de cribado de CCR se inició en el año 2000. La población, comprendida entre 50 y 69 años residentes en el área, fue invitada a participar a través de la determinación bienal de sangre oculta en heces mediante el test guaiaco y colonoscopia en los participantes con test positivo. Se realizó polipectomía de las lesiones detectadas o biopsias cuando no era posible la extirpación. Los pólipos se clasificaron según criterios de la Organización Mundial de la Salud.Resultados: se realizaron 442 colonoscopias de los 495 test positivos. En 213 individuos, se detectaron: 36 cánceres invasivos, 121 adenomas de alto riesgo, 29 adenomas de bajo riesgo y 27 pólipos hiperplásicos. En el 25,8% de los casos, el tamaño de los adenomas fue < 10 mm. La mayoría de las lesiones diagnosticadas (37,2%) estaban localizadas en el colon distal, el 5,7% a nivel proximal y ambas localizaciones en el 5,2%. Las neoplasias avanzadas se asociaron significativamente al sexo masculino y la localización distal. La prevalencia de neoplasias avanzadas a nivel proximal entre los pacientes sin pólipos distales fue del 5,1%.Conclusiones: los adenomas de alto riesgo de localización distal han sido las lesiones detectadas con mayor frecuencia. El cribado poblacional mediante la determinación de sangre oculta en heces es un método factible para detectar pequeñas lesiones precancerosas, factor clave para disminuir la incidencia de CCR.Palabras clave: Cáncer colorrectal. Programa de cribado. Riesgo poblacional. Test de sangre oculta en heces. Test guaiaco. Neoplasia avanzada. ABSTRACTObjective: to evaluate lesions detected in two screening rounds performed in a pilot screening program for colorectal cancer in Catalonia, Spain.Material and methods: a colorectal cancer screening program was initiated in 2000. The target population included men and women aged 50-69 years. Screening consisted of biennial guaiac-based fecal occult blood testing (FOBT), and colonoscopy for participants with a positive FOBT. Any polyps found were removed, and biopsies were performed for any masses.Results: Colonoscopies were performed in 442 of 495 people with positive FOBT. In 213 (48.2%), 36 invasive cancers, 121 high-risk adenomas, 29 low-risk adenomas, and 27 hyperplastic polyps were diagnosed. Lesion size was smaller than 10 mm in 25.8% of cases. Most detected lesions (37.2%) were located in the distal colon, followed by the proximal colon (5.7%) and both locations (5.2%). Advanced neoplasm was significantly associated with male gender and distal location. The prevalence of advanced proximal neoplasms among patients with no distal polyps was 5.1%.Conclusions: the most common lesions detected by colonoscopy were high-risk adenomas located in the distal colon. FOBT is a suitable method for detecting small precancer lesions during population screening, ...

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Lessons learnt from a population-based pilot programme for colorectal cancer screening in Catalonia (Spain)

Abstract: Regardless of the moderate participation rate, population-based colorectal cancer screening would be feasible in Catalonia, with good results in terms of prevalence of screen-detected neoplasms.

Cited by 76 publications

References 49 publications

Status of implementation and organization of cancer screening in The European Union Member States—Summary results from the second European screening report

Status of implementation and organization of cancer screening in The European Union Member States—Summary results from the second European screening report

French colorectal cancer screening pilot programme: results of the first round

Hallazgos colonoscópicos del estudio piloto de cribado de cáncer colorrectal realizado en Cataluña

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