Results from the evaluation of colorectal cancer screening in the Czech Republic

Česká verzia

Authors: Ngo O. ^1,2 ; Chloupková R. ^1,2 ; Štěpán Suchánek ^3,4 ; M. Ambrožová ^1,2 ; Hejcmanová K. ^1,2 ; P. Dvořák ¹ ; Miroslav Zavoral ^3,4 ; K. Hejduk ^1,2 ; L. Dušek ^1,2 ; Májek O. ^1,2
Authors place of work: Národní screeningové centrum, Ústav zdravotnických informací a statistiky České republiky, Praha ¹; Institut biostatistiky a analýz, LF MU, Brno ²; Interní klinika 1. LF UK a ÚVN – VFN Praha ³; Ústav gastrointestinální onkologie, ÚVN – VFN Praha ⁴
Published in the journal: Gastroent Hepatol 2023; 77(5): 385-393
Category: Gastrointestinal Oncology: Original Article
doi: https://doi.org/10.48095/ccgh2023385

Summary

Introduction: Colorectal cancer screening, which was introduced in the Czech Republic in 2000, plays an important role in reducing the population burden. It is necessary to continuously evaluate the organised population-based program and introduce necessary adjustments to ensure its high effectiveness, which in the long term leads to a reduction in the incidence and mortality of the disease. The aim of this article is to summarise and discuss the key results of the evaluation of the National Colorectal Cancer Screening Program based on available national data. Material and methods: The evaluation used the registries of the National Health Information System, the Registry of Preventive Colonoscopies, and data on population demographics managed by the Czech Statistical Office. The analysis was carried out on available data up to 2021. Basic indicators were calculated in accordance with international recommendations, which were adapted for the Czech environment. Results: A number of performance indicators for colorectal screening demonstrate the negative impact of the COVID-19 pandemic in 2020 and 2021. Coverage of the target population by screening has stabilised at around 30% before the pandemic. Considering a three-year interval, the full coverage of the target population by screening reaches around 50%. Participation rates for follow-up colonoscopy after a positive faecal occult blood test (FOBT) screening ranged between 60 and 70% over time. FOBT screening positivity increased in the recent years up to 10%, which is reflected in the increase in the average waiting time for follow-up FOBT+ colonoscopy. Despite the identified limitations of the screening program, there has been a clear long-term decline in colorectal cancer incidence and mortality. Conclusion: The comprehensive screening information system enables the evaluation of colorectal screening. The evaluated indicators show that despite the positive impact of the screening program on the population burden, it still has its opportunities for improvement, and therefore it is essential to continue its monitoring in order to improve the quality of the whole program.

Keywords:

registries – colonoscopy – mass screening – colorectal neoplasms – performance indicators – program evaluation – occult blood

Zdroje

Sung H, Ferlay J, Siegel RL et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021; 71 (3): 209–249. doi: 10.3322/caac.21660.
Ferlay J, Ervik M, Lam F et al. Global Cancer Observatory: Cancer Today. 2023 [online]. Dostupné z: https: //gco.iarc.fr/today/ home.
Dušek L, Mužík J, Kubásek M et al. Epidemiologie zhoubných nádorů v České republice. 2023 [online]. Dostupné z: https: //www.svod.cz.
Wild C, Stewart BW, World Health Organization, International Agency for Research on Cancer. World Cancer Report 2014. International Agency for Research on Cancer; 2014.
Lauby-Secretan B, Vilahur N, Bianchini F et al. The IARC Perspective on Colorectal Cancer Screening. N Engl J Med 2018; 378 (18): 1734–1740. doi: 10.1056/NEJMsr1714643.
Brenner H, Stock C, Hoffmeister M. Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies. BMJ 2014; 348: g2467. doi: 10.1136/bmj.g2467.
Lin JS, Perdue LA, Henrikson NB et al. Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2021; 325 (19): 1978–1998. doi: 10.1001/jama.2021.4417.
European Council. Council Recommendation of 2 December 2003 on cancer screening. 2003 [online]. Dostupné z: https: //eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ: L: 2003: 327: 0034: 0038: EN: PDF.
Májek O, Králová K, Lopourová A et al. Nové doporučení Rady Evropské unie o screeningu nádorových onemocnění. Med Pro Praxi 2023; 20 (2): 90–93. doi: 10.36290/med.2023. 013.
Ponti A, Anttila A, Ronco G et al. Cancer Screening in the European Union (2017). Report of the Implementation of the Council Recommendation on Cancer Screening; 2017. Dostupné z: https: //health.ec.europa.eu/system/files/2017-05/2017_cancerscreening_2ndreportimplementation_en_0.pdf.
Suchanek S, Majek O, Vojtechova G et al. Colorectal cancer prevention in the Czech Republic: time trends in performance indicators and current situation after 10 years of screening. Eur J Cancer Prev 2014; 23 (1): 18–26. doi: 10.1097/CEJ.0b013e328364f203.
Májek O, Zavoral M, Suchánek Š et al. Kolorektum.cz – Program kolorektálního screeningu v České republice. 2023 [online]. Dostupné z: https: //www.kolorektum.cz/.
van Rossum LG, van Rijn AF, Laheij RJ et al. Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population. Gastroenterology 2008; 135 (1): 82–90. doi: 10.1053/j.gastro.2008.03. 040.
Grega T, Májek O, Ngo O et al. Současné principy screeningu kolorektálního karcinomu – od oportunního k populačnímu screeningovému programu. Gastroent Hepatol 2016; 70 (5): 383–392. doi: 10.14735/amgh2016383.
Zavoral M, Vojtěchová G, Májek O et al. Population colorectal cancer screening in the Czech Republic. Cas Lek Cesk 2016; 155 (1): 7–12.
Chloupková R, Ngo O, Suchánek Š et al. Program kolorektálního screeningu v České republice – hodnocení výkonnosti center za rok 2021. Gastroent Hepatol 2022; 76 (5): 379–385. doi: 10.48095/ccgh2022379.
Ngo O, Bučková B, Suchánek Š et al. Participation of the Czech population in the Colorectal Cancer Screening Programme – trends and current situation. Gastroent Hepatol 2017; 71 (5): 377–383. doi: 10.14735/amgh2017377.
Dušek L, Májek O, Blaha M et al. Koncepce populačního screeningu v České republice, metodika a první výsledky adresného zvaní občanů do preventivních onkologických programů. Klin Onkol 2014; 27 (2): 2S59–2S68. doi: 10.14735/amko20142S59.
Ngo O, Chloupková R, Ambrožová M et al. Vyhodnocení adresného zvaní českých občanů do screeningových programů. Cas Lek Cesk 2019; 158 (3–4): 147–150.
Segnan N, Patnick J, von Karsa L. European Guidelines for Quality Assurance in Colorectal Cancer Screening and Diagnosis – First Edition. Publications Office ot the European Union; 2010 [online]. Dostupné z: https: //www.kolorektum.cz/res/file/guidelines/CRC-screening-guidelines-EC-2011-02-03.pdf.
Ministerstvo zdravotnictví ČR – Příkaz ministra č. 14/2023. 2023 [online]. Dostupné z: https: //ppo.mzcr.cz/upload/files/zakladni-dokumenty-pm-2023-14-jednaci-rad-a-status-komise-kolorektalni-karcinom-63f9ea06a625a.pdf.
Ministerstvo zdravotnictví ČR – Zdraví 2020 – Národní strategie ochrany a podpory zdraví a prevence nemocí. 2023 [online]. Dostupné z: https: //www.mzcr.cz/zdravi-2020-narodni-strategie-ochrany-a-podpory-zdravi-a-prevence-nemoci-2/.
Ministerstvo zdravotnictví ČR – Zdraví 2030. 2023 [online]. Dostupné z: https: //www.mzcr.cz/category/programy-a-strategie/zdravi-2030/22.
Ngo O, Hejcmanová K, Suchánek Š et al. Coverage by examinations associated with early detection of colorectal neoplasia in the Czech Republic. Eur J Public Health 2023; 33 (3): 515– –521. Dostupné z: doi: 10.1093/eurpub/ckad071.
Suchánek Š, Ngo O, Grega T et al. Aktuální zkušenosti a výzvy v programu screeningu kolorektálního karcinomu. 2023 [online]. Dostupné z: https: //prevon.uzis.cz/res/file/prezentace/2022/20-suchanek.pdf.
Ministerstvo zdravotnictví ČR – Oznámení ve věci úpravy Věstníku MZ ČR částka 1/2009 Standard při poskytování a vykazování screeningu nádorů kolorekta. 2023 [online]. Dostupné z: https: //www.mzcr.cz/wp-content/uploads/2023/08/KRK_01-Zneni-Oznameni-MZ-ve-veci-upravy-Vestniku_3.pdf.