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Five-year experience of organized colorectal cancer screening in a Swedish population - increased compliance with age, female gender, and subsequent screening round.

https://arctichealth.org/en/permalink/ahliterature257918
Source
J Med Screen. 2014 Sep;21(3):144-50
Publication Type
Article
Date
Sep-2014
Author
Johannes Blom
Sini Kilpeläinen
Rolf Hultcrantz
Sven Törnberg
Author Affiliation
Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden johannes.blom@ki.se.
Source
J Med Screen. 2014 Sep;21(3):144-50
Date
Sep-2014
Language
English
Publication Type
Article
Keywords
Aged
Colonoscopy
Colorectal Neoplasms - diagnosis - epidemiology
Early Detection of Cancer - statistics & numerical data
Female
Humans
Male
Mass Screening - statistics & numerical data
Middle Aged
Occult Blood
Patient Compliance - statistics & numerical data
Sweden - epidemiology
Abstract
To evaluate compliance by age, gender, and screening round in the population based Stockholm/Gotland colorectal cancer screening programme.
All individuals aged between 60 and 69 living in the counties of Stockholm and Gotland (Sweden) have, since 2008, successively been included in a colorectal cancer screening programme using biennial faecal occult blood tests (Hemoccult?). Personal invitations including test kits have been sent to home addresses, and individuals with a positive test result have been called to a defined clinic for an assessment colonoscopy. Descriptive statistics have been used to evaluate different aspects of compliance.
Over the five-year period 2008-2012, more than 200,000 individuals from nine different birth cohorts have been invited, with a compliance rate of approximately 60%, which increased by age, female gender, and subsequent screening round. In total, 4,300 individuals (2.1%) with positive tests were referred to assessment colonoscopy, where 213 colorectal cancers were diagnosed. The compliance with the follow-up colonoscopies varied by year, and ranged from 85.6-92.4%.
The strong organization of the programme contributed to a high compliance rate, that increased by screening round. The lower participation rate among men and among individuals at younger ages needs further attention.
PubMed ID
25070434 View in PubMed
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Interval cancers in a guaiac-based colorectal cancer screening programme: Consequences on sensitivity.

https://arctichealth.org/en/permalink/ahliterature290740
Source
J Med Screen. 2017 Sep; 24(3):146-152
Publication Type
Journal Article
Date
Sep-2017
Author
Johannes Blom
Sven Törnberg
Author Affiliation
1 Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Source
J Med Screen. 2017 Sep; 24(3):146-152
Date
Sep-2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Colorectal Neoplasms - diagnosis - epidemiology
Early Detection of Cancer
Female
Guaiac
Humans
Male
Mass Screening - methods - standards
Middle Aged
Occult Blood
Prospective Studies
Registries
Sensitivity and specificity
Sweden - epidemiology
Abstract
Objective To evaluate interval cancers in the population-based colorectal cancer screening programme of Stockholm/Gotland, Sweden. Methods From 2008, individuals aged 60-69 were invited to colorectal cancer screening using biennial guaiac-based faecal occult blood test (Hemoccult®). Interval cancers, defined as colorectal cancer among participants not diagnosed by the screening programme but registered in the Swedish cancer register, were evaluated by cross-checking the screening histories for all cancers in the region 2008-2012. Results Of 203,848 individuals from nine different birth cohorts who participated (~60%), 4530 (2.2%) tested positive. All invited individuals were followed up for 24 months after invitation. The cancer register reported 557 colorectal cancer, 219 (39.3%) screen-detected cancers and 338 (60.7%) interval cancers, generating both test- and episode sensitivities of approximately 40% and an interval cancer-rate of 17.1/10,000 tests. Among individuals with positive tests without colorectal cancer diagnosed at work-up colonoscopy, 37 interval cancers (10.9%) occurred. There was statistically significant lower sensitivity in women, ranging 22.4-32.2%, compared with 43.2-52.0% in men. Age-group and tumour location were not strongly correlated to screen-detected cancer rates. The programme sensitivity increased by year (20.3-25.0%), with successively more colorectal cancers diagnosed within the expanding programme (11.6-16.2%). Conclusion Interval cancer is a quality indicator of a screening programme. As the interval cancer-rate determined in a well-organized population-based screening programme was actually higher than the screen-detected cancer rate, a change to a more sensitive screening test is indicated. The lower screen-detected cancers among women, and compliance and quality of work-up colonoscopies also need attention.
PubMed ID
28142309 View in PubMed
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