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  • In the invitation letter it is stated that citizens

    2019-08-16

    In the invitation letter it BYL-719 is stated that citizens already enrolled in a surveillance programme after being diagnosed with colorectal cancer or adenoma should not participate. It is also stated that citizens with inflammatory bowel disease (IBD) should discuss with the gastroenterologist in charge of their surveillance or treatment of IBD, whether participation is relevant. A citizen can request a new FIT test if the prior one is lost or damaged. Citizens not participating within 45 days receive a written reminder [7].
    Results The performance indicators of all invitations mailed in the first 34 months of the Danish National Colorectal Cancer Screening Programme (3 March 2014 – 31 December 2016) are shown in Table 1, Table 2. Table 1 shows the outcome among invited men. In total 710,433 men were invited and 58.4% participated. Due to the invitation schedule the number of invited in age group 50–54 years and 70–74 years are higher than the number of invitations in the other age groups. Among the participating men with a suitable test, 8.3% had a positive test and 89.5% of those accepted to have a follow-up procedure (colonoscopy/sigmoidoscopy/CT colonography) performed. The remaining 10.5% of the participating men either never had a follow-up procedure after the screening test or had a follow-up procedure more than 6 months after the positive test. Among the 30,773 men having colonoscopy less than 6 months after a positive test, 1933 were diagnosed with colorectal cancer (6.3%) and 14,973 (48.5%) with at least one adenoma. In total 33,367 adenomas were send to analysis in a pathology department. Of these 2212 (6.6%) showed high-grade neoplasia on histological examination(s). The outcome among invited females is shown in Table 2. In total 727,403 females were invited and 66.6% participated. Among the participating females with a suitable test, 5.7% had a positive test and 88.8% of those accepted to have a follow-up procedure. The remaining 11.2% of the participating females either never had a follow-up procedure after the screening test or had a follow-up procedure more than 6 months after the positive test. Among the 24,217 females having colonoscopy less than 6 months after a positive test, 5.1% were diagnosed with colorectal cancer and 38.6% with at least one adenoma. In total 15,958 adenomas were send to the pathologists. Of these 1134 (7.1%) showed high-grade neoplasia on histological examination(s). Table 3 shows the outcome for all citizens invited to colorectal cancer screening during the first 34 months of the Danish National Colorectal Cancer Screening Programme (3 March 2014 – 31 December 2016) together with the acceptable level, the desirable level and the level from the first screening round in population-based studies using FIT. As seen in Table 1, Table 2, a total of 1,437,836 citizens were invited 3 March 2014 to 31 December 2016 and 899.441 (62.6%) choose to participate within 135 days of the invitation. Thus the participation rate (or uptake rate) was 62.6%. Table 3 shows proton the participation rate was well above the acceptable level of >45% and close to the desirable level of >65%. The following performance indicators also fulfilled the acceptable level and the desirable level or came close to the desirable level: ‘Follow-up colonoscopy compliance rate', 'completion of follow-up colonoscopy after FIT’ and ‘rate of high-grade neoplasia reported by pathologists’. The 'inadequate FIT rate' was far below both the acceptable and the desirable level. The ‘uptake rate’, 'positive FIT rate', 'follow-up colonoscopy compliance rate' and 'cancer detection rate' were all in line with the level from the first screening round in other population-based studies, whereas 'adenoma detection rate' and 'PPV for detection of adenomas' were above the level from the first screening round in other population-based studies. To follow the definitions in the European Guidelines 'follow-up colonoscopy compliance rate' includes in the nominator those rare cases, in which follow-up colonoscopy was not possible, but sigmoideoscopy or CT colonography were performed.