Gastrointestinal CancerThe impact of 6 years of the National Colorectal Cancer Screening Program on colorectal cancer incidence and 5-year survivalTepeš, Bojana; Mlakar, Dominika Novakb; Stefanovič, Milanc; Štabuc, Borutd; Grazio, Snježana Frkovičd; Zakotnik, Jožica Maučecb Author Information aAM DC Rogaška, Department of Gastroenterology, Rogaška Slatina bNational Institute for Public Health, Department SVIT, Ljubljana cDC Bled, Department of Gastroenterology, Bled dUniversity Clinical Center, Clinical department of Gastroenterology, Ljubljana, Slovenia Received 29 May 2020 Accepted 25 June 2020 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.eurjcancerprev.com). Correspondence to Bojan Tepeš, MD, FEBGH, PhD, AM DC Rogaška, Department of Gastroenterology Prvomajska 29A, 3250 Rogaška Slatina, Slovenia, Tel: +00386 3 8191413; e-mail: [email protected] European Journal of Cancer Prevention 30(4):p 304-310, July 2021. | DOI: 10.1097/CEJ.0000000000000628 Buy SDC Metrics Abstract We aimed to assess the impact of the first three rounds of the National Colorectal Cancer Screening Program (NCCSP) on CRC incidence and mortality in Slovenia. In NCCSP, we use two fecal immune tests (FITs) and if test is positive patient is referred to colonoscopy. From 2009, we invite Slovenian residents aged 50–69 years, one screening round takes 2 years. The response rate was from 56.9 to 59.9%. FIT was positive in 6.0–6.2% (more in older patients and in men; P < 0.05). The adenoma detection rate was >51.3% (more in men; P < 0.01). In NCCSP, 70.3% of all cancers diagnosed were in stages I and II, while 20.7% of all CRC were found in polyps resected during colonoscopies. Patients with positive first FIT have odds ratio 2.19 [95% confidence interval (CI), 2.06–2.32] for advanced neoplasia and cancer compared to patients with two negative FITs. The incidence rate for CRC has dropped significantly after 6 years in population and in men (P < 0.01) but not in women. Five-year CRC survival was 31.3% higher if cancer was diagnosed in NCCSP (P < 0.05). After 6 years of NCCSP, the incidence rate for CRC has dropped significantly (P < 0.01). Hazard ratio for death from CRC was 3.84 higher (95% CI, 3.36–4.40; P < 0.001) in patients with cancer detected outside the program. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.