Abstract
The population-based Basque Colorectal Cancer (CRC) Screening Programme started in 2009 with a biennial immunochemical quantitative test (FIT) biennial and colonoscopy under sedation in positive cases. The population target of 586,700 residents was from 50 to 69 years old and the total coverage was reached at the beginning of 2014. The aim of our study was to determine possible scenarios in terms of incidence, mortality and reduction of Life-years-Lost (L-y-L) in the medium and long term of CRC.MethodsInvitations were sent out by the Programme from 2009 to 2014, with combined organizational strategies. Simulation was done by MISCAN-colon (Microsimulation Screening Analysis) over 30 years comparing the results of screening vs no-screening, taking the population-based Cancer Registry into account. Lifetime population and real data from the Programme were used from 2008 to 2012. The model was run differentially for men and women.Results924,416 invitations were sent out from 2009 to 2014. The average participation rate was 68.4%, CRC detection rate was 3.4% and the Advanced Adenoma detection rate was 24.0‰, with differences observed in sex and age. Future scenarios showed a higher decrease of incidence (17.2% vs 14.7%), mortality (28.1% vs 22.4%) and L-y-L (22.6% vs 18.4%) in men than women in 2030.ConclusionsThe Basque Country CRC Programme results are aligned to its strategy and comparable to other programmes. MISCAN model was found to be a useful tool to predict the benefits of the programme in the future. The effectiveness of the Programme has not been formally established as case control studies are required to determine long term benefits from the screening strategy.
Highlights
Colorectal cancer (CRC) is the third leading cancerrelated cause of death in developed countries
Outcomes of the population-based Basque CRC screening Programme 924,416 individuals were invited (2009–2014), with an average participation rate of 68.4% representing an incremental increase over the study period (58.1% 70.3%)
The Basque Country CRC Programme results are aligned to its strategy and comparable to other programmes
Summary
Colorectal cancer (CRC) is the third leading cancerrelated cause of death in developed countries. The European Union (EU) has the highest incident rate and ranks second in mortality of both sexs, with 446,000 newly-diagnosed cases each year and a mortality rate estimated in 214,000 cases annually [1]. In the Basque Country, one of the 17 autonomous regions of Spain, it is the most frequent type of cancer. Different screening strategies have been proposed to reduce the CRC incidence and mortality, by means of different diagnostic tests. Evidence of the reduction in mortality using the guaiac test (gFOBT) for population-based screening, showed a reduction in mortality of 10–16% [3,4,5]
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