How does colorectal screening (CRS) work in European countries?

Jelena Danilenko, Michael Harris

Keywords: Colorectal cancer screening , Immunological faecal occult blood test.

Background:

As the population ages and lifestyles change, a rapid increase in the number of cancer cases is expected. Cancer is the leading cause of death worldwide in countries of all income levels, however some types of cancer can be treated effectively if diagnosed at an early stage and adequate therapy is initiated. Given the high mortality rates, secondary prevention is important. Worldwide, the main form of early detection of cancer is through population-based screening programmes with the aim of detecting the tumour at an early stage and initiating treatment.

Research questions:

How does colorectal screening (CRS) work in European countries?

Method:

A 7-question survey which was distributed during the Split EGPRN meeting. The questions asked about personal-professional experience of CRS.

Results:

28 questionnaires from delegates in 19 countries were returned. Colorectal cancer screening uptake was above the uptake recommended in the European guidelines (45%) in six countries: Israel (80%), Finland (73.5%), UK (70.3%), Netherlands (70%), Slovenia 64.6-75%), Denmark (61-64%). In Belgium, the Flemish government response rate was 64.1%. The faecal immunochemical test was most commonly used, with the most common target age-group 50-74 years. All countries surveyed screened once every two years, except Israel (yearly) and possibly Croatia (every 3 years). Only Macedonia had not developed a colorectal cancer screening programme.

Conclusions:

This short, anonymous questionnaire provided an insight into colorectal cancer screening in Europe. Israel had the best uptake of the surveyed countries, and only Israel had yearly testing. In 10 of the surveyed countries, the recommended minimum uptake was not reached.

Points for discussion:

• Why is it difficult for countries to achieve the colorectal cancer screening uptake that is recommended in the European guidelines?

• Which CRS programme/method is best, and why?

• How can we improve CRS uptake?

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