Colorectal cancer screening: 20 years of development and recent progress

Table 1 Time trends for incidence rates for colorectal cancer in the Czech Republic and neighboring countries

Cancer registry	Colorectal cancer incidence-ASR (E)
	1990	2000	Trend 1990-2000	2007	Trend 2000-2007
Czech Republic	50.3	62.7	+25%	59.0	-6%
Germany, Saarland	58. 8	61.7	+5%	58.7	-5%
Slovakia	41.7	55.7	+33%	57.9	+4%
Austria	48.8	49.4	+1%	41.8	-16%
Poland, Kielce	19.1	34.3	+80%	35.7	+4%

Source of data: Steliarova-Foucher et al[21] ECO; Czech National Cancer Registry. ASR (E): Number per 100000 population, age-standardized rate (European).

Table 2 Characteristics of selected fecal occult blood test colorectal cancer screening projects including personal invitations

Country	Age group (yr), test	Time period	Procedure in personal invitation	Participation rate	Source
Studies and pilot projects
England	50-69	2000-2004	Centralized invitations by the screening unit	F: 59%	Weller et al[67], 2007
	gFOBT		Sending fecal occult blood test (FOBT) test kits	SM: 48%	UKCRCSPG[66], 2004
				SW: 56%
France	50-74	2003-2006	Centralized invitations according to sickness fund database files	FM: 54%	Denis et al[59], 2007
	gFOBT		Invitation to general practitioners (GP), reminder after 6 mo, FOBT kit reminder 4 mo later	FW: 57%
			Exclusions by GP: serious illness, recent colorectal cancer (CRC) screening, high CRC risk
Netherlands	50-74	2006-2007	Centralized invitations	gFOBT:	Hol et al[60], 2010
	gFOBT, FIT		Exclusions: Inflammatory bowel disease (IBD), CRC, recent CRC screening	50%
			Pre-invitation, sending test kits after 2 wk, reminder after 6 wk	FIT: 62%
Scotland	50-69	2000-2007	Centralized invitations by the screening center	FM: 50%, FW: 60%	Steele et al[65], 2009
	gFOBT		Sending FOBT test kits	SM: 49%, SW: 57%
			Reminder-second kit-after 6 wk (kit in first round only)
Spain	50-69	Since 2000	Centralized invitations	FM: 17%, FW: 18%	Peris et al[64], 2007
	gFOBT		Exclusions: CRC, adenoma, high CRC risk	SM: 21%, SW: 24%
			Invitation-reply-sending test kit, reminder after 6 wk
Population-based screening programs
England	60-69	Since 2006	Centralized invitations by the screening center	M: 50%	Logan et al[61], 2012
	gFOBT		People registered with a GP practice	W: 54%
			Sending FOBT test kits
Finland	60-69	Since 2004	Centralized invitations by the national screening center	FM: 62%, FW: 77%	Malila et al[48], 2011
	gFOBT		using Population Register Center	SM: 68%, SW: 80%	Malila et al[63], 2008
			Sending FOBT test kits		Malila et al[62], 2005

F: First round of screening; S: Second round of screening; M: Men; W: Women; gFOBT: Guaiac fecal occult blood test; FIT: Fecal immunochemical test.

Table 3 Basic characteristics of preventive colonoscopies performed within the Czech colorectal cancer screening program, 2006-2012

Basic characteristics	Year	Patients with CS	Patients with detected adenoma	Proportion1	Patients with detected CRC	Proportion1
FOBT+ CS	2006	5334	1578	29.6%	335	6.3%
	2007	5679	1635	28.8%	337	5.9%
	2008	7457	2367	31.7%	446	6.0%
	2009	11712	3778	32.3%	599	5.1%
	2010	18327	6235	34.0%	829	4.5%
	2011	20131	7134	35.4%	733	3.6%
	2012	21112	7788	36.9%	770	3.6%
	Total	89752	30515	34.0%	4049	4.5%
Screening CS	2009	1362	345	25.3%	24	1.8%
	2010	4400	1076	24.5%	43	1.0%
	2011	4571	1160	25.4%	42	0.9%
	2012	4480	1138	25.4%	35	0.8%
	Total	14813	3719	25.1%	144	1.0%
Total		104565	34234	32.7%	4193	4.0%

Source: Czech colorectal cancer (CRC) Screening Registry.

¹Proportions of detected neoplasia represent the positive predictive value for fecal occult blood test (FOBT) + colonoscopies (CS) and the detection rate for screening CS.