Evaluation of colorectal cancer screening centers in the Czech Republic

Česká verzia

Authors: O. Ngo ^1,2; B. Bučková ^1,2; Š. Suchánek ³; M. Zavoral ³; L. Dušek ^1,2; O. Májek ^1,2
Authors place of work: Ústav zdravotnických informací a statistiky ČR, Praha ¹; Institut biostatistiky a analýz, LF MU, Brno ²; Interní klinika 1. LF UK a ÚVN, Praha ³
Published in the journal: Gastroent Hepatol 2018; 72(5): 379-384
Category: Gastrointestinal Oncology: Original Article
doi: https://doi.org/10.14735/amgh2018379

Summary

Backgrounds:

The Czech republic has a leading position in the incidence and mortality of colorectal cancer compared to other European countries. Screening programs are an essential part of prevention policies in the Czech Republic. The success of these programs depend on the continuous monitoring of the screening process. The aim of the paper is to evaluate the performance of preventive colonoscopies performed in the Czech Republic in accordance with established recommendations.

Material and Methods:

Data on preventive colonoscopies performed in centers for screening colonoscopy (Centers), which are collected in a central database, were used to evaluate key performance indicators, including cecal intubation rate, detection rate of screening colonoscopy, and positive predictive value (PPV) of fecal occult blood test (FOBT). Performance indicators were evaluated in accordance with the published recommendations of the Czech Gastroenterological Society.

Results:

About 25% of centers did not achieve the desirable cecal intubation rate (95%), but most of these reached at least the minimally acceptable rate of 90%. The reference value of the proportion of detected adenoma was met in most Centers (93%), but high variability was observed across Centers (10.2–74.8%). A similar situation was observed within evaluation by gender and indication. In particular, low PPV of FOBT may be associated with high FOBT positivity and possibly unnecessary colonoscopies.

Conclusion:

Some Centers did not reach the reference values of the performance indicators, especially the cecal intubation rate. Limited FOBT PPV observed in some centers shows that there is room for program improvement. Efforts should be made to formulate and implement actions to optimize the program at the level of participating Centers.

Key words:

colorectal cancer – mass screening – performance indicators – colonoscopy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted: 18. 9. 2018

Accepted: 10. 10. 2018

Zdroje

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