Colorectal cancer screening in countries of European Council outside of the EU-28

Table 1 Number of cases and standardized colorectal cancer burden in women and men in EU-19, 2012 (Adapted from Ferlay et al[4])

Country	WOMAN						MAN
	Incidence		5-yr prevalence		Mortality		Incidence		5-yr prevalence		Mortality
	Cases	ASR (W)	Cases	%	Cases	ASR (W)	Cases	ASR (W)	Cases	%	Cases	ASR (W)
Albania	167	7.9	501	39.9	90	4.0	175	9.0	526	42.0	97	4.8
Andorra	NR
Armenia	4.4	17.0	939	68.6	281	9.7	426	22.8	855	77.1	261	13.4
Azerbaijan	346	6.4	209	4.0	755	19.8	313	7.1	661	18.5	187	4.3
Bosnia and Herzegovina	489	13.3	1427	84.8	327	7.7	620	20.7	1811	119.1	422	12.7
Georgia	300	7.5	608	31.3	173	4.0	305	9.9	631	38.3	177	5.5
Iceland	79	28.3	238	183.6	21	5.8	78	28.9	232	177.5	27	9.3
Liechtenstein	NR
Republic of Moldova	716	23.0	1736	111.0	409	12.6	799	36.0	1963	143.2	491	22.0
Monaco	NR
Montenegro	107	21.1	314	118.7	67	12.0	157	36.2	465	187.3	95	20.7
Norway	1947	35.8	5665	279.6	779	12.1	1966	42.6	5839	289.8	727	14.3
Russian Fed	33183	21.8	78454	119.1	21791	12.7	26745	30.0	63572	116.4	18116	19.9
San Marino	NR
Serbia	2143	23.3	6281	151.4	1213	11.5	3370	43.4	9919	248.8	1922	22.8
Switzerland	2167	23.6	6522	193.8	718	6.4	2707	36.3	8340	259.9	1668	12.8
FYR Macedonia'	366	20.5	1070	124.0	213	10.8	421	28.4	1256	147.3	239	15.5
Turkey	5041	13.1	10690	38.2	3030	7.8	6889	20.6	14982	54.7	4128	12.6
Ukraine	9780	19.9	23110	109.6	5704	10.8	6269	29.9	22120	127.8	5929	18.8
EU-28	151920	24.4	417252	189.0	69087	9.0	193426	39.5	535845	257.8	82959	15.2

EU-28: Countries members of European Union; NR: Not Reported; ASR (W): Per 100000.

Table 2 Quality assessment of Epidemiological data source and methods according to Mathers et al[17]

Data source
EU-19	EU-19	EU-28	EU-28
Incidence	Mortality	Incidence	Mortality
A: Iceland Norway, Ukraine	1: Iceland, Republic of Moldova	A: Austria, Belgium, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Ireland, Latvia, Lithuania, Malta, Sweden, Slovenia,Slovakia, The Netherlands, United Kingdom, Finland, France (Martinique)	1: Estonia, Hungary, Ireland, Latvia, Lithuania, Malta, Slovenia, Slovakia, Romania, United Kingdom, Finland
B: Serbia, Switzerland	2: Azerbaijan, Norway, Russian Federation, Serbia, Switzerland
C: Turkey			2: Austria, Belgium, Bulgaria, Croatia, Czech Republic, Denmark, France, Germany, Italy, Luxembourg, Spain, Sweden, The Netherlands, France (Guadalupe), (La Reunion), France (Martinique), France (Guiana)
D: Bosnia Herzegovina, Russian Federation		B: France, Germany, Italy, Spain
	3: Albania, Armenia, FYR Macedonia	C: Portugal, Poland
E: -		D: Luxembourg, France (La Reunion)
F: -	4: -	E: Romania
G: Albania, Armenia, Azerbaijan, FYR Macedonia, Georgia, Montenegro, Republic of Moldova	5: Bosnia Herzegovina	F: -
	6: Georgia, Montenegro, Turkey	G: Greece, Hungary, France (Guadalupe), France (Guiana)
			3: Greece, Portugal, Poland
			4: - 5: - 6: -
Methods
EU-19	EU-28	EU-19	EU-28
Incidence	Mortality	Incidence	Mortality
1: Iceland, Norway	1: Albania, FYR Macedonia, Iceland, Norway, Republic of Moldova, Serbia, Switzerland	1: Austria, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, Germany, Ireland, Latvia, Lithuania, Malta, Slovakia, Slovenia, Sweden The Netherlands, United Kingdom, France (La Reunion), France (Martinique)	1: Austria. Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France (metropolitan) Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, The Netherlands, United Kingdom, France (Martinique)
2: Bosnia Herzegovina, Ukraine
3: Turkey, Switzerland	2: Armenia, Azerbaijan, Bosnia Herzegovina, Georgia, Ukraine
4: Albania, FYR Macedonia, Republic of Moldova, Serbia
		2: Belgium, Cyprus
	3: - 4: -	3: France (metropolitan) , Germany, Italy, Poland, Spain
5: Armenia, Azerbaijan, Georgia	5: Turkey
	6: Montenegro	4: Greece, Hungary, Luxembourg, Portugal
6: Turkey		5: Romania, France (Guadalupe),	2: Belgium, Cyprus, France (Guadalupe)
7: - 8: -		6: - 7: - 8: - 9: -
9: Montenegro			3: Greece, Portugal, Poland
			4: -
			5: France (La Reunion)
			6: -

Comparison between EU-19 and EU-28 countries, as defined in the main text. -: No country classified in that category.

Table 3 Distribution of colorectal cancer screening programmes in EU-19 as of December 2015

Country	Program			Test	Screening interval (yr)	Age (yr)	Program start	Pop target	Level of participation (%)
	Type	Status	Region
Federation of Bosnia and Heregovina[22]	Spontaneous	NatW	All country	FOBT	-	> 50	-	-	-
	Organised
Republika Srpska[22]	Spontaneous	NatW	All country	FOBT	-	> 50	-	-	-
Georgia[51]	Organised	NatW	Tblisi	gFOBT	2	50-69	-	25388	53
			OutsideTblisi	gFOBT	2	50-69	-	71364	84
Iceland[18]	Programmed as organised	NatW	All country	FOBT	2	55-75[19]	-	86000[19]
Iceland[19]	Spontaneous	NatW	All country	Colonoscopy		50-59			30
Monaco[35]	PB	Natw	All country	iFOBT	2	50-80	2006	16000[35]	60
				(from 2015)
				gFOBT
Montenegro[22,28]	None	-	-	-	-	-	-	-	-
Montenegro[28]	Not PB	PilotStudy	Danilograv, municipality of Podgorica	iFOBT	-	50-74	2010-2011	4500	33.3
Norway[20]	PB	Pilot Study	Østfold, Akershus and Buskerud	iFOBT	2		2012
Norway[21]	PB	Pilot Study RCT	Oslo and Telemark in 1999-2001 NORCAPP	FOBT and FOBT + Sigmoidoscopy	-	55-64	1999-2000	13823	64.8
Russian Fed[42]	PB	Pilot Study	Sant Petersburb, all 18 town district	iFOBT		48-75	November 15	20000
Russian Fed[43]	NPB	Pilot Study	Kazan, Tatarstan Republic	FOBT, DRE, questionnaire	-		2010	1071
San Marino[36,37]	PB	Natw	All country	iFOBT	2	50-79	2009		65[37]
Serbia[31]	PB	Natw	All country	iFOBT	2	50-74		789330	58.38
Switzerland[32]	Spontaneous	NatW	All country	FOBT or Colonoscopy	2, 10	50-80	2013	13170	22
Switzerland[33]	PB	Pilot Study RCT	Glarus, Vallée du Joux Uri	FOBT and or Colonoscopy	-	50-80	2001	20000
Switzerland[34]	PB	Pilot Study, NRCT	Vaud	iFOBT or Colonoscopy		50-69	2015
Turkey[44]	Organised	NatW		FOBT		50-69	2009	11681513	30[44]
	Spontaneous
Ukraine[46,54]	PB	NatW		Not available	Not available	Not available	2002-2006		Not available

gFOBT: Guaiac test; iFOBT: Immunological test; FOBT: Not specified if gFOBT or iFOBT; DRE: Digital rectal exam; NPB: Not population-based.

Table 4 National cancer profiles

Country	Income1	Total population	Cancer registry	Availability at public primary health care levels of early detection tests		Ranking CRC incidence2		Ranking CRC mortality2
				Faecal occult blood test	Bowel cancer screening by exam or colonoscopy	Man	Woman	Man	Woman
North Europe
Iceland2	High	326000	National, population-based	-	-	3rd	3rd	2nd	4th
Norway2	High	4994000	National, population-based	Yes	-	2nd	2nd	3rd	2nd
Central Europe
Liechtenstein3	High non OECD	36925	NA	-	-	2nd	3rd	NR	NR
Monaco	High non OECD	38000	Hospital-based	Yes	Yes	NR	NR	NR	NR
Switzerland3	High	7997000	Sub-national population-baseda	Yes	Yes	2nd	2nd	3rd	3rd
South Europe
Andorra	High non OECD	78000	Hospital-based	Yes	Yes	NR	NR	NR	NR
San Marino	High non OECD	31000	National population-based	Yes	Yes	NR	NR	NR	NR
Balcanian countries
Albania3	Upper middle	3162000	Sub-national, hospital-based	-	-	> 5th	5th	> 5th	5th
Bosnia and Herzegovina3	Upper middle	3834000	NA	-	-	3rd	2nd	2nd	3rd
Montenegro3	Upper middle	621000	NA	-	-	2nd	2nd	2nd	3rd
Serbia3	Upper middle	9553000	Sub-national	Yes	Yes	2nd	2nd	2nd	3rd
FYR of Macedonia3	Upper middle	2106000	National	Yes	-	3rd	3rd	2nd	2nd
Eastern Europe
Republic of Moldova3	Lower middle	3514000	National, hospital-based	Yes	Yes	2nd	2nd	2nd	2nd
Russian Fed3	High non OECD	143000000	Sub-national, population-basedb	Yes	Yes	3rd	2nd	3rd	2nd
Turkey3	Upper middle	73997000	Sub-national population-basedc	Yes	Yes	4th	3rd	4th	3rd
Ukraine3	Lower middle	45530000	National, population-based	-	-	2nd	2nd	2nd	2nd
Caucasican countries
Armenia3	Lower middle	2969000	National, hospital-based	Yes	-	5th	3rd	4th	2nd
Azerbaijan3	Upper middle	9309000	NA	Yes	-	4th	4th	5th	5th
Georgia3	Lower middle	4358000	Sub-national population-based	-	-	5th	> 5th	5th	> 5th

OECD (Organization for Economic Co-operation and Development):

¹It referred to pro capita Gross National Income (current US$) as indicated by World Bank: High income $382742014; High Income non OECD: $18939; Upper middle $79012014; Lower middle $2012;

²Incidence and mortality between different cancers for country: data from http://www.who.int/cancer/country-profiles/en/adapted for each country;

³Data available from: http://assets.krebsliga.ch/downloads/fl2014.pdf;

^aRegistry in Zurich, Vaud, Valais, Ticino, St Gall-Appenzell, Neuchâtel, Graubünden and Glarus, Geneva, Basel;

^bRegistry in Saint Petersburg;

^cRegistry in Trabzon, Izmir, Erdine, Antalya. Information about registry existence are available from Ref. [46]. NA: Not available; NR: Not reported; CRC: Colorectal cancer.