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Faecal immunochemical test-based colorectal cancer screening programme SVIT in Slovenia: pilot phase

Tepeš, Bojana; Štabuc, Borutb; Stefanovič, Milane; Bračko, Matejc; Frkovič Grazio, Snežanac; Novak Mlakar, Dominikad; Maučec Zakotnik, Jožicad

European Journal of Cancer Prevention: July 2014 - Volume 23 - Issue 4 - p 235–239
doi: 10.1097/CEJ.0b013e3283651c9e
Research Papers: Gastrointestinal Cancer

Colorectal cancer (CRC) is the second most common cancer in Slovenia. The 5-year survival of patients depends on the clinical stage at presentation. More than 70% of patients with CRC are diagnosed as being in stage III or IV, with a 5-year survival rate of 52.7%. To improve the detection rate of CRC and to detect CRC in its early and more curable stage, a national screening programme is needed. In the year 2008, we started a pilot phase of the National CRC screening programme. We invited 9091 Slovene residents aged 64–68 years from Ljubljana, Kranj, and Celje regions, of whom 3807 responded to our invitation (41.9%). Two kits of the faecal immune test were sent to 3117 participants who met the inclusion criteria, and 2829 (90.7%) tests were returned. The compliance rate in our pilot programme was 32.9%. Among the patients who responded positively, 7.5% were positive. Until February 2009, 193 colonoscopies had been performed at DC Bled, DC Lipa and AM DC Rogaška. Intubation to the caecum was carried out in 99.4% of colonoscopies. Histology specimens were taken from 135 patients (70%). The adenoma detection rate was 53.8% (59.8% for men and 47.9% for women; P<0.05). We detected 1–17 adenomas per patient (2.4 on average). Advanced adenomas were detected in 60 patients (31%; 35.1% of men and 27.1% of women; P<0.05). Invasive carcinoma was detected in 15 patients (7.7%; 12.4% of men and 3.1% of women; P<0.05). Ten of them (73.3%) were in clinical stage I or II. In the pilot phase of the CRC screening programme the majority of CRCs were detected at early clinical stages. Invasive cancers were detected in 7.7% of patients. In almost all patients adenomas were resected at screening colonoscopy, thus reducing the possibility of later development of CRC in those patients.

aAM DC Rogaska, Rogaška Slatina

bDepartment of Gastroenterology, University Clinical Center

cDepartment of Pathology, Institute for Oncology

dSVIT, National Institute of Public Health, Ljubljana

eDC Bled, Bled, Slovenia

Correspondence to Bojan Tepeš, MD, FEBGH, PhD, AM DC Rogaška, Prvomajska 29 A, 3250 Rogaška Slatina, Slovenia Tel: +386 3 8191411; fax: +386 3 8191412; e-mail: bojan.tepes@siol.net

Received May 12, 2013

Accepted July 12, 2013

© 2014 Lippincott Williams & Wilkins, Inc.