Proportion and stage distribution of screen-detected and non-screen-detected colorectal cancer in nine European countries: an international, population-based study

Cardoso, Rafael; Guo, Feng; Heisser, Thomas; Schutter, Harlinde De; Damme, Nancy Van; Nilbert, Mef; Tybjerg, Anne Julie; Bouvier, Anne-Marie; Bouvier, Véronique; Launoy, Guy; Woronoff, Anne‐Sophie; Cariou, Mélanie; Robaszkiewicz, Michel; Delafosse, Patricia; Poncet, F.; Walsh, Paul; Senore, Carlo; Rosso, Stefano; Lemmens, Valery; Elferink, M.A.G.; Tomšič, Sonja; Žagar, Tina; Marques, Arantza Lopez de Munain; Marcos‐Gragera, Rafael; Puigdemont, Montse; Galcerán, Jaume; Carulla, Marià; Sánchez-Gil, Antonia; Chirlaque, María‐Dolores; Hoffmeister, Michael; Brenner, Hermann

doi:10.1016/s2468-1253(22)00084-x

Cited by 23 publications

(16 citation statements)

References 30 publications

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“…Implementation of screening initiatives have positively impacted early detection and mortality rates, with the largest decreases in mortality rates seen in countries with longstanding programs [3,4]. In Europe, the highest proportion of screen-detected CRC (40–60%) was reported in regions and countries with well-established screening programs, while in most other regions and countries the proportions of screen-detected cancers were below 30% [5]. It is important to highlight that high adherence rates were reported in countries with the greatest proportions of screening-detected CRC [5].…”

Section: Introductionmentioning

confidence: 99%

“…In Europe, the highest proportion of screen-detected CRC (40–60%) was reported in regions and countries with well-established screening programs, while in most other regions and countries the proportions of screen-detected cancers were below 30% [5]. It is important to highlight that high adherence rates were reported in countries with the greatest proportions of screening-detected CRC [5]. Nonetheless, the effectiveness of organized screening at a nationwide level is directly related to the participation rate as lower adherence rates leads to a lower effect on mortality decrease and higher costs [6].…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of the PERCEPT-PREVENT tool to determine risk perception and attitudes towards digestive cancer screening

Silva,

Santos,

Dinis-Ribeiro

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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Background and aims Colorectal cancer (CRC) screening is recommended worldwide, while gastric cancer (GC) screening may also be defendable in some settings. However, adherence rates and factors influencing participation are not well characterized. This study aimed to validate a tool to determine risk perception of CRC and GC and also of endoscopy-related complications. Methods A questionnaire in CRC risk perception based on the Health Belief Model was used. Forward/backward translation (English-Portuguese) and cultural adaptation were performed. After revision by a panel of experts, the questionnaire was adapted to target GC risk perception and perceptions towards endoscopy-related complications. The final version of the questionnaire (PERCEPT-PREVENT tool) was applied to 44 individuals, through telephonic interview, at enrolment and at intervals ≤3 weeks. Test–retest reliability and agreement were assessed. Results Almost perfect reliability between test and retest was obtained for CRC symptom knowledge score (ICC = 0.88), risk factor knowledge score (ICC = 0.89), and perceived severity (ICC = 0.84). At least moderate agreement between test and retest was obtained for GC symptom knowledge score (ICC = 0.94), risk factor knowledge score (ICC = 0.92), and perceived severity (ICC = 0.58). Test-retest reliability was assessed for barrier domains [faecal occult blood test ICC = 0.63; colonoscopy ICC = 0.79; upper GI endoscopy (UGIE) ICC = 0.83]. A total of 91% and 98% of participants gave the same answer in the test and retest for preferred method of CRC screening and intention to undergo UGIE for GC screening combined with a screening colonoscopy, respectively. Discussion PERCEPT-PREVENT is a valid and reliable tool for CRC and GC risk perception evaluation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development and validation of the PERCEPT-PREVENT tool to determine risk perception and attitudes towards digestive cancer screening

Silva,

Santos,

Dinis-Ribeiro

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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“…Given these considerations, added to the fact that the vast majority of CRC cases are still discovered in symptomatic subjects ( 16 ), it is critical to achieve the greatest possible FIT uptake patterns rate and increase the effectiveness of CRC detection programs, with a specific emphasis on the factors that impact uptake. For this reason, the aims of this study were to estimate the prevalence and evolution over time of uptake patterns to FIT as a screening test for CRC among individuals aged 50–69 in Spain, and to determine the predictive factors for uptake patterns to this screening test based on sociodemographic, health, and lifestyle characteristics.…”

Section: Introductionmentioning

confidence: 99%

Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020

Cruz

Cebrino

2023

Front. Public Health

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BackgroundAlthough population screening has improved the early diagnosis of colorectal cancer (CRC), most cases are diagnosed in symptomatic patients. This study aimed to estimate the prevalence and evolution over time of uptake patterns to fecal immunochemical test (FIT) as a screening test for CRC among individuals aged 50–69 in Spain, and to determine the predictive factors for uptake patterns to this type of screening based on sociodemographic, health, and lifestyle characteristics.MethodsA cross-sectional study with 14,163 individuals from the 2017 Spanish National Health Survey and the 2020 European Health Survey was performed, including as the main variable uptake pattern to FIT screening within the last 2 years, with which we analyzed sociodemographic factors, health status and lifestyle habits.Results38.01% of participants had undergone FIT in the previous 2 years, and from 2017 to 2020, a significant increase in the uptake rate for CRC was observed (2017: 32.35%, 2020: 43.92%, p < 0.001). The positive predictors to FIT uptake pattern included factors such as being between 57 and 69 years, having a higher educational level or a higher social class, having at least one chronic illness, frequent contact with the primary care physician, alcohol consumption and physical activity, while immigration and smoking habit were negative predictors.ConclusionIn Spain, although the evolution of FIT uptake pattern over time is positive, the prevalence of FIT uptake is still low (38.01%), not reaching the level considered as acceptable in the European guidelines. Moreover, there are disparities in CRC screening uptake among individuals.

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“…[14][15][16][17] Lastly, population-based screening programs have been implemented in several countries, 18 identifying patients with asymptomatic CRC. 19 While most of the initiatives have been associated with better outcomes individually, nationwide population-based studies are needed to investigate the implications of these initiatives for the risk of recurrence.…”

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confidence: 99%

Incidence of Recurrence and Time to Recurrence in Stage I to III Colorectal Cancer

Nors,

Iversen,

Erichsen

et al. 2024

JAMA Oncol

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ImportanceManagement of colorectal cancer (CRC) has been updated continuously over the past 2 decades. While the combination of these initiatives has had implications for improved survival, the implications for rates of recurrence remain unexplored.ObjectiveTo ascertain the rates of recurrence and describe time to recurrence within 5 years of surgery with curative intent for stages I to III CRC.Design, Setting, and ParticipantsThis cohort study used the Danish Colorectal Cancer Group Database to identify patients with Union for International Cancer Control (UICC) stages I to III CRC who underwent primary surgery between January 1, 2004, and December 31, 2019. They were followed up until recurrence (event), death (competing event), diagnosis of a second cancer (competing event), emigration (censoring event), 5 years postoperatively (censoring event), or January 1, 2023 (censoring event), whichever came first. Recurrence status was ascertained through individual-level linked data from the Danish Cancer Registry, Danish National Patient Registry, and Danish Pathology Registry using a validated algorithm. Data were analyzed from January 1 to August 8, 2023.ExposurePrimary surgery performed during 3 calendar periods (2004-2008, 2009-2013, and 2014-2019) stratified by tumor site (colon or rectum) and UICC stage (I, II, and III).Main Outcomes and MeasuresStage-specific 5-year recurrence reported as the cumulative incidence function (CIF) of recurrence, the association between calendar period of primary surgery and recurrence risk reported as subdistribution hazard ratios (sHRs), and the time from surgery to recurrence.ResultsOf the 34 166 patients with UICC stages I to III CRC (median [IQR] age, 70 [62-77] years); 18 552 males [54.3%]) included in the study, 7027 developed recurrence within 5 years after the primary surgery. For colon cancer, the 5-year CIF of recurrence decreased over the 3 calendar periods from 16.3% to 6.8% for UICC stage I, from 21.9% to 11.6% for UICC stage II, and from 35.3% to 24.6% for UICC stage III colon cancer. For rectal cancer, the 5-year CIF decreased over the 3 periods from 19.9% to 9.5% for stage I, from 25.8% to 18.4% for stage II, and from 38.7% to 28.8% for stage III disease. Patients with stage III disease had a shorter time from surgery to recurrence compared with those with stage I disease (time ratio stage III vs stage I = 0.30; 95% CI, 0.28-0.32). Cancers detected through screening were associated with lower stage-adjusted risks of recurrence (sHR, 0.81; 95% CI, 0.73-0.91) compared with cancers not detected through screening.Conclusions and RelevanceIn this cohort of patients with CRC, the risk of recurrence decreased in patients with stages I to III disease during the study period. Cancer detection by screening was associated with an even lower risk of recurrence. Time to recurrence differed according to UICC stage. Because the risk of recurrence was so low in selected patient groups, future research is warranted to explore risk-stratified surveillance protocols in patients with CRC.

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Proportion and stage distribution of screen-detected and non-screen-detected colorectal cancer in nine European countries: an international, population-based study

Cited by 23 publications

References 30 publications

Development and validation of the PERCEPT-PREVENT tool to determine risk perception and attitudes towards digestive cancer screening

Development and validation of the PERCEPT-PREVENT tool to determine risk perception and attitudes towards digestive cancer screening

Uptake patterns and predictors of colorectal cancer screening among adults resident in Spain: A population-based study from 2017 to 2020

Incidence of Recurrence and Time to Recurrence in Stage I to III Colorectal Cancer

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