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Results of the FIT-based National Colorectal Cancer Screening Program in Slovenia

Tepeš, Bojan, MD, PhD*; Bracko, Matej, MD, PhD; Novak Mlakar, Dominika, MD; Stefanovic, Milan, MD§; Stabuc, Borut, MD, PhD; Frkovic Grazio, Snjezana, MD, PhD; Maucec Zakotnik, Jozica, MD

Journal of Clinical Gastroenterology: July 2017 - Volume 51 - Issue 6 - p e52–e59
doi: 10.1097/MCG.0000000000000662
ONLINE ARTICLES: Original Article

Background: Colorectal cancer (CRC) is one of the most common malignancies in the western world.

Objective: We aimed to assess the first round of fecal immunochemical test (FIT)-based National CRC screening program (NCSP).

Methods: In the NCSP conducted in Slovenia, a FIT and colonoscopy for those tested positive was used. The NCSP central unit sent 536,709 invitations to Slovenian residents age 50 to 69 years old between 2009 and 2011. The adherence rate was 56.9% (303,343 participants). FIT was positive in 6.2% (15,310) of the participants (men, 7.8%; women, 5.0%; P<0.01). A total of 13,919 unsedated colonoscopies were performed with the cecal intubation rate of 97.8%.

Results: The overall adenoma detection rate was 51.3% [95% confidence interval (CI), 50.5%-52.1%] of which 61.0% (95% CI, 59.9%-62.1%) was in men, and 39.1% (95% CI, 37.8%-40.3%) in women (P<0.01). The mean number of adenoma per positive colonoscopy was 1.94 (95% CI, 1.90-1.97). Adenoma, advanced adenoma, or cancer were found in 7732 (55.5%) colonoscopies. A total of 862 (6.2%) CRC cases were found. Only 161 (18.7%) carcinomas were situated in the right colon. A total of 597 (70.2%) patients with cancer were in the early clinical stages (N, negative; 194 22.8%) of all cancers were cured with only endoscopic resection.

Conclusions: In the NCSP, CRC was found in 6.2% of those participants attending colonoscopy, with 81.3% of carcinomas found in the left colon. A localized clinical stage was found in 70.2% participants. In 22.8% of CRC patients, cancer was cured with endoscopic resection only.

*AM DC Rogaška, Rogaška Slatina

University Clinical Center

National Institute for Public Health, Ljubljana

§DC Bled, Bled, Slovenia

B.T. analyzed the data, and wrote the manuscript; M.B., D.N.M., and S.F.G. contributed to analyzing the data and contributed to writing the manuscript; M.S., B.S., and J.M.Z. contributed to writing the manuscript.

The authors declare that they have nothing to disclose.

Address correspondence to: Bojan Tepeš, MD, PhD, AM DC Rogaška, Prvomajska 29A, Rogaška Slatina 3250, Slovenia (e-mail:

Received April 25, 2016

Accepted July 12, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.