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Endoscopy 2012; 44(S 03): SE49-SE64
DOI: 10.1055/s-0032-1309788
Guidelines
© Georg Thieme Verlag KG Stuttgart · New York

European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition – Evaluation and interpretation of screening outcomes

S. Moss
1   Centre for Cancer Prevention, Wolfson Institute, Queen Mary University of London, United Kingdom
,
R. Ancelle-Park
2   Direction Générale de la Santé, Paris, France
,
H. Brenner
3   German Cancer Research Center, Heidelberg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
25 September 2012 (online)

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Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on evaluation and interpretation of screening outcomes includes 20 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multi-disciplinary diagnosis and management of the disease.

Keywords

mass screening - colorectal neoplasms - evaluation - monitoring - screening outcomes - evidence-based guidelines - population-based programmes

7 equal to the defined screening interval or reporting period, e. g. 12 months in the case of yearly reporting.


8 equal to the defined screening interval or reporting period


 

  • References

  • 1 Atkin W, Valori R, Kuipers EJ et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition. Colonoscopic surveillance following adenoma removal. Endoscopy 2012; 44: SE151-SE163
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Austoker J, Giordano L, Hewitson P et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition. Communication. Endoscopy 2012; 44: SE164-SE185
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Brotherstone H, Vance M, Edwards R et al. Uptake of population-based flexible sigmoidoscopy screening for colorectal cancer: a nurse-led feasibility study. J Med Screen 2007; 14: 76-80
    CrossrefPubMedSearch in Google Scholar
  • 4 Chrissidis T, Saliangas K, Economou A et al. Mass screening for colorectal cancer: compliance in Almopea Region. Tech Coloproctol 2004; 8: s193-s195
    CrossrefPubMedSearch in Google Scholar
  • 5 Council of the European Union. Council Recommendation of 2 December 2003 on cancer screening (2003/878/EC). Off J Eur Union; 2003: 34-38
    PubMedSearch in Google Scholar
  • 6 Crotta S, Castiglione G, Grazzini G et al. Feasibility study of colorectal cancer screening by immunochemical faecal occult blood testing: results in a northern Italian community. Eur J Gastroenterol Hepatol 2004; 16: 33-37
    CrossrefPubMedSearch in Google Scholar
  • 7 Day NE, Williams DR, Khaw KT. Breast cancer screening programmes: the development of a monitoring and evaluation system. Br J Cancer 1989; 59: 954-958
    CrossrefPubMedSearch in Google Scholar
  • 8 Denis B, Ruetsch M, Strentz P et al. Short term outcomes of the first round of a pilot colorectal cancer screening programme with guaiac based faecal occult blood test. Gut 2007; 56: 1579-1584
    CrossrefPubMedSearch in Google Scholar
  • 9 Faivre J, Arveux P, Milan C et al. Participation in mass screening for colorectal cancer: results of screening and rescreening from the Burgundy study. Eur J Cancer Prev 1991; 1: 49-55
    PubMedSearch in Google Scholar
  • 10 Federici A, Marinacci C, Mangia M et al. Is the type of test used for mass colorectal cancer screening a determinant of compliance? A cluster-randomized controlled trial comparing fecal occult blood testing with flexible sigmoidoscopy. Cancer Detect Prev 2006; 30: 347-353
    CrossrefPubMedSearch in Google Scholar
  • 11 Fenocchi E, Martinez L, Tolve J et al. Screening for colorectal cancer in Uruguay with an immunochemical faecal occult blood test. Eur J Cancer Prev 2006; 15: 384-390
    CrossrefPubMedSearch in Google Scholar
  • 12 Ferlay J, Shin HR, Bray F et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. [Internet] Lyon, France: International Agency for Research on Cancer; 2010 Available from: http://globocan.iarc.fr Accessed on 05/04/2012
    PubMedSearch in Google Scholar
  • 13 Gondal G, Grotmol T, Hofstad B et al. The Norwegian Colorectal Cancer Prevention (NORCCAP) screening study: baseline findings and implementations for clinical work-up in age groups 50-64 years. Scand J Gastroenterol 2003; 38: 635-642
    CrossrefPubMedSearch in Google Scholar
  • 14 Grazzini G, Castiglione G, Ciabattoni C et al. Colorectal cancer screening programme by faecal occult blood test in Tuscany: first round results. Eur J Cancer Prev 2004; 13: 19-26
    CrossrefPubMedSearch in Google Scholar
  • 15 Halloran S, Launoy G, Zappa M. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition. Faecal Occult Blood Testing. Endoscopy 2012; 44: SE65-SE87
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Hardcastle JD, Chamberlain JO, Robinson MH et al. Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet 1996; 348: 1472-1477
    CrossrefPubMedSearch in Google Scholar
  • 17 Hart AR, Glover N, Howick-Baker J et al. An industry based approach to colorectal cancer screening in an asymptomatic population. Postgrad Med J 2003; 79: 646-649
    CrossrefPubMedSearch in Google Scholar
  • 18 Hol L, van Leerdam ME, van Ballegooijen M et al. Screening for colorectal cancer: randomised trial comparing guaiac-based and immunochemical faecal occult blood testing and flexible sigmoidoscopy. Gut 2010; 59: 62-68
    CrossrefPubMedSearch in Google Scholar
  • 19 Hosek RS, Flanders WD, Sasco AJ. Bias in case-control studies of screening effectiveness. Am J Epidemiol 1996; 143: 193-201
    CrossrefPubMedSearch in Google Scholar
  • 20 Karim-Kos HE, de Vries E, Soerjomataram I et al. Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s. Eur J Cancer 2008; 44: 1345-1389
    CrossrefPubMedSearch in Google Scholar
  • 21 Kewenter J, Brevinge H, Engaras B et al. Results of screening, rescreening, and follow-up in a prospective randomized study for detection of colorectal cancer by fecal occult blood testing. Results for 68,308 subjects.. Scand J Gastroenterol 1994; 29: 468-473
    CrossrefPubMedSearch in Google Scholar
  • 22 Kronborg O, Fenger C, Olsen J et al. Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet 1996; 348: 1467-1471
    CrossrefPubMedSearch in Google Scholar
  • 23 Landsorp-Vogelaar I, von Karsa L. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition 1. Introduction. Endoscopy 2012; 44: SE15-SE30
    Thieme ConnectPubMedSearch in Google Scholar
  • 24 Lieberman DA, Weiss DG, Bond JH et al. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380.. N Engl J Med 2000; 343: 162-168
    CrossrefPubMedSearch in Google Scholar
  • 25 Malila N, Oivanen T, Malminiemi O et al. Test, episode, and programme sensitivities of screening for colorectal cancer as a public health policy in Finland: experimental design. BMJ 2008; 337: 2261
    CrossrefPubMedSearch in Google Scholar
  • 26 Malila N, Senore C, Armaroli P. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition. Organisation. Endoscopy 2012; 44: SE31-SE48
    Thieme ConnectPubMedSearch in Google Scholar
  • 27 Mandel JS, Bond JH, Church TR et al. Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study.. N Engl J Med 1993; 328: 1365-1371
    CrossrefPubMedSearch in Google Scholar
  • 28 Minozzi S, Armaroli P, Banzi R et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis – First edition. Appendix 1: Systematic evidence review. 2010 http://bookshop.europa.eu/en/european-guidelines-for-quality-assurance-in-colorectal-cancer-screening-and-diagnosis-pbND3210390/ Accessed 11/2/2012
    PubMedSearch in Google Scholar
  • 29 Minozzi S, Armaroli P, Segnan N. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition. Principles of evidence assessment and methods for reaching recommendations. Endoscopy 2012; 44: SE9-SE14
    Thieme ConnectPubMedSearch in Google Scholar
  • 30 Moss SM, Hardcastle JD, Coleman DA et al. Interval cancers in a randomized controlled trial of screening for colorectal cancer using a faecal occult blood test. Int J Epidemiol 1999; 28: 386-390
    CrossrefPubMedSearch in Google Scholar
  • 31 NHS. Bowel Screening Programme Clinical Standards. Scotland: NHS Quality Improvement; 2007 http://www.bowelscreening.scot.nhs.uk/wp-content/uploads/2007/06/bowelsc_stnf_feb07.pdf Accessed 11/2/2012
    PubMedSearch in Google Scholar
  • 32 Peris M, Espinas JA, Munoz L et al. Lessons learnt from a population-based pilot programme for colorectal cancer screening in Catalonia (Spain). J Med Screen 2007; 14: 81-86
    CrossrefPubMedSearch in Google Scholar
  • 33 Quirke P, Risio M, Lambert R et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition. Quality assurance in pathology in colorectal cancer screening and diagnosis. Endoscopy 2012; 44: SE116-SE130
    Thieme ConnectPubMedSearch in Google Scholar
  • 34 Regula J, Rupinski M, Kraszewska E et al. Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med 2006; 355: 1863-1872
    CrossrefPubMedSearch in Google Scholar
  • 35 Saito H. Colorectal cancer screening using immunochemical faecal occult blood testing in Japan. J Med Screen 2006; 13 (Suppl. 01) 6-S7
    PubMedSearch in Google Scholar
  • 36 Schoenfeld P, Cash B, Flood A et al. Colonoscopic screening of average-risk women for colorectal neoplasia. N Engl J Med 2005; 352: 2061-2068
    CrossrefPubMedSearch in Google Scholar
  • 37 Segnan N, Patnick J, von Karsa L (eds.) European guidelines for quality assurance in colorectal cancer screening and diagnosis – First edition. Luxembourg: European Commission, Publications Office of the European Union; 2010
    Search in Google Scholar
  • 38 Segnan N, Senore C, Andreoni B et al. Randomized trial of different screening strategies for colorectal cancer: patient response and detection rates. J Natl Cancer Inst 2005; 97: 347-357
    CrossrefPubMedSearch in Google Scholar
  • 39 Segnan N, Senore C, Andreoni B et al. Baseline findings of the Italian multicenter randomized controlled trial of "once-only sigmoidoscopy"--SCORE. J Natl Cancer Inst 2002; 94: 1763-1772
    CrossrefPubMedSearch in Google Scholar
  • 40 Segnan N, Senore C, Andreoni B et al. Comparing attendance and detection rate of colonoscopy with sigmoidoscopy and FIT for colorectal cancer screening. Gastroenterology 2007; 132: 2304-2312
    CrossrefPubMedSearch in Google Scholar
  • 41 Steele RJC, Pox C, Kuipers EJ et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition. Management of lesions detected in colorectal cancer screening. Endoscopy 2012; 44: SE31-SE48
    Thieme ConnectPubMedSearch in Google Scholar
  • 42 Steele RJC, Rey J-F, Lambert R. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition. Professional requirements and training. Endoscopy 2012; 44: SE15-SE30
    Thieme ConnectPubMedSearch in Google Scholar
  • 43 UK Flexible Sigmoidoscopy Screening Trial Investigators. Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial. Lancet 2002; 359: 1291-1300
    CrossrefPubMedSearch in Google Scholar
  • 44 Valori R, Rey J-F, Atkin W et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis: First edition. Quality assurance in endoscopy in colorectal screening and diagnosis. Endoscopy 2012; 44: SE88-SE105
    Thieme ConnectPubMedSearch in Google Scholar
  • 45 Viiala CH, Olynyk JK. Outcomes after 10 years of a community-based flexible sigmoidoscopy screening program for colorectal carcinoma. Med J Aust 2007; 187: 274-277
    PubMedSearch in Google Scholar
  • 46 von Karsa L, Anttila A, Ronco G et al. Cancer Screening in the European Union. Report on the implementation of the Council Recommendation on Cancer Screening – First Report. Luxembourg: European Commission; 2008 http://ec.europa.eu/health/archive/ph_determinants/genetics/documents/cancer_screening.pdf Accessed 11/2/2012
    PubMedSearch in Google Scholar
  • 47 von Karsa L, Lignini TA, Patnick J et al. The dimensions of the CRC problem. Best Pract Res Clin Gastroenterol 2010; 24: 381-396
    CrossrefPubMedSearch in Google Scholar
  • 48 Weissfeld JL, Schoen RE, Pinsky PF et al. Flexible sigmoidoscopy in the PLCO cancer screening trial: results from the baseline screening examination of a randomized trial. J Natl Cancer Inst 2005; 97: 989-997
    CrossrefPubMedSearch in Google Scholar
  • 49 Weller D, Coleman D, Robertson R et al. The UK colorectal cancer screening pilot: results of the second round of screening in England. Br J Cancer 2007; 97: 1601-1605
    CrossrefPubMedSearch in Google Scholar
  • 50 Wilson JM, Jungner YG. Principles and practice of mass screening for disease. World Health Organization; 1968 http://whqlibdoc.who.int/php/WHO_PHP_34.pdf Accessed 11/2/2012
    PubMedSearch in Google Scholar
  • 51 Zappa M, Castiglione G, Paci E et al. Measuring interval cancers in population-based screening using different assays of fecal occult blood testing: the District of Florence experience. Int J Cancer 2001; 92: 151-154
    CrossrefPubMedSearch in Google Scholar
  • 52 Zorzi M, Falcini F, Fedato C et al. Screening for colorectal cancer in Italy: 2006 survey. Epidemiol Prev 2008; 32: 55-68
    PubMedSearch in Google Scholar