Subscribe to RSS
DOI: 10.1055/s-0039-1681623
A SYNTHETIC PREDICTOR OF THE IMPACT OF COLORECTAL CANCER SCREENING PROGRAMMES ON INCIDENCE RATES
Publication History
Publication Date:
18 March 2019 (online)
Aims:
Diagnosis and the removal of pre-cancerous lesions within colorectal cancer (CRC) screening programmes based on the faecal immunochemical test (FIT) reduces CRC incidence rates.
The impact of a screening programme on CRC incidence depends on a large number of variables, including the actual extension of invitations, participation rate, positivity rate of the screening test, compliance with invitation to second level assessment, endoscopist accuracy.
We propose a synthetic indicator that accounts for all the variables influencing the impact of a screening programme on incidence rates.
Methods:
We developed the “rate of Advanced Adenoma on the Target Population” (AA-TAP) as the rate of patients who received a diagnosis of advanced adenoma within a screening programme divided by the programme target population.
We computed the AA-TAP for the CRC Italian screening programmes using the data of the Italian National Survey from 2009 to 2016, overall and by Region.
Results:
In 2016, the actual extension of CRC screening programmes in Italy (i.e. the proportion of subjects of the annual target population who were regularly invited) was 76%, and the participation rate was 41%. Positivity rate was 5.4% at first FIT and 4.5% at subsequent FITs; compliance rate with colonoscopy was 82%. The detection rate for advanced adenoma was 8.1‰ at first and 6.2‰ at subsequent round.
The AA-TAP at a national level was 105 × 100,000, while significant differences were observed between the Northern and Central Regions (respectively 141 and 150 × 100,000) and the South and Islands (29 × 100,000).
The AA-TAP at a national level was stable on values slightly higher than 100 × 100,000 from 2010 to 2016.
Conclusions:
The AA-TAP summarises into a single indicator the potential impact of a screening programme in reducing CRC incidence rates. It may be useful when comparing different programmes, particularly if they have different screening protocols.
#