Decreased Colorectal Cancer Incidence and Incidence-Based Mortality in the Screening-Age Population of Ontario

Paszat, Lawrence; Sutradhar, Rinku; Corn, Elyse; Tinmouth, Jill; Baxter, Nancy N.; Rabeneck, Linda

doi:10.1093/jcag/gwaa035

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…The Canadian Task Force on Preventive Health Care and the Canadian Association of Gastroenterology recommend performing colonoscopy within 2 months after FOBT1 (5,13), and organized programs consider 6-month colonoscopy completion within their quality-monitoring frameworks (6,(14)(15)(16)(17). Although colonoscopy utilization has risen in the past 2 decades in Ontario overall (18), follow-up rates for FOBT1 have consistently remained below the national target of 85% (16,19).…”

Section: Introductionmentioning

confidence: 99%

Effect of Chronic Comorbidities on Follow-up Colonoscopy After Positive Colorectal Cancer Screening Results: A Population-Based Cohort Study

et al. 2022

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INTRODUCTION: Fecal occult blood tests (FOBTs) are colorectal cancer screening tests used to identify individuals requiring further investigation with colonoscopy. Delayed colonoscopy after positive FOBT (FOBT1) is associated with poorer cancer outcomes. We assessed the effect of comorbidity on colonoscopy receipt within 12 months after FOBT1. METHODS:Population-based healthcare databases from Ontario, Canada, were linked to assemble a cohort of 50-74-year-old individuals with FOBT1 results between 2008 and 2017. The associations between comorbidities and colonoscopy receipt within 12 months after FOBT1 were examined using multivariable cause-specific hazard regression models. RESULTS:Of 168,701 individuals with FOBT1, 80.5% received colonoscopy within 12 months. In multivariable models, renal failure (hazard ratio [HR] 0.71, 95% confidence interval [CI] 0.62-0.82), heart failure (HR 0.77, CI 0.75-0.80), and serious mental illness (HR 0.88, CI 0.85-0.92) were associated with the lowest colonoscopy rates, compared with not having each condition. The number of medical conditions was inversely associated with colonoscopy uptake ( ‡4 vs 0: HR 0.64, CI 0.58-0.69; 3 vs 0: HR 0.75, CI 0.72-0.78; and 2 vs 0: HR 0.87, CI 0.85-0.89). Having both medical and mental health conditions was associated with a lower colonoscopy uptake relative to no comorbidity (HR 0.88, CI 0.87-0.90).

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Section: Introductionmentioning

confidence: 99%

Effect of Chronic Comorbidities on Follow-up Colonoscopy After Positive Colorectal Cancer Screening Results: A Population-Based Cohort Study

et al. 2022

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Impact of organised colorectal cancer screening on age-specific population incidences: evidence from a quasi-experimental study in Sweden

Chauca Strand,

Strömberg,

Forsberg

et al. 2024

Eur J Epidemiol

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Colorectal cancer (CRC) incurs a significant disease burden globally. Organised CRC screening programmes have been widely implemented for early detection and prevention. To understand the public health impact of these programmes, quantitative evidence of changes in overall and age-specific population incidences is fundamental. We aimed to provide such evidence by exploiting a time lag in the implementation of organised screening in Sweden: two out of 21 regions (these two regions comprise nearly 20% of the total Swedish population) have offered organised screening since 2008; the other regions have offered CRC screening since 2021. Using registry data on diagnosed CRC cases and socio-demographics for all regions in Sweden over the period 1970–2019, Bayesian structural time series modelling and difference-in-differences were applied to analyse the impact of screening on age-specific population incidences over time (CRC cases per 100.000 persons/year). After inviting birth-year cohorts aged 60–69 years for stool-based testing, the incidence rate in the 70–74-year age group decreased significantly over time, with an average reduction of − 44·40 (95% CI − 58·15 to − 31·31) from 2011 to 2019 in the intervention regions. In the overall population aged 60–74 years, there was a net incidence decrease of − 7·99 (95% CI − 13·85 to − 2·39) since the initiation of organised screening in the intervention regions (2008–2019). Organised CRC screening for 60–69-year-olds generated a change in age-specific incidence patterns with a long-lasting incidence decrease in the 70–74-year-old population, implying reductions in the excess mortality and burden of the disease.

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Development of a National Colorectal Cancer Screening Research Agenda: An Initiative of the Canadian Screening for Colorectal Cancer Research Network (CanSCCRN)

Kendell,

Urquhart,

Kyei

et al. 2024

Current Oncology

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The Canadian Screening for Colorectal Cancer Research Network (CanSCCRN) recently set out to develop a national CRC screening research agenda and identify priority research areas. The specific objectives were to (1) identify evidence gaps relevant to CRC screening and the barriers and facilitators to evidence generation and uptake by CRC screening programs, (2) establish high-priority collaborative research ideas to inform best CRC screening practices, and (3) identify one to two research topics for grant development and submission within 12 to 18 months. Three focus groups were conducted with network members and relevant parties (n = 15) to identify evidence gaps, barriers, and facilitators to evidence generation and uptake. Three workshops were subsequently held to discuss focus group findings and develop an action plan for research. An electronic survey was used to prioritize the evidence gaps to be addressed. Overall, five categories of barriers and six categories of facilitators to evidence uptake and generation were identified, as well as 23 evidence gaps to be addressed. Screening participation, post-polypectomy surveillance, and screening age range were identified as research priority research areas. Adequate resourcing and infrastructure, as well as partnerships with knowledge end users, are integral to addressing these research areas and advancing CRC screening programs in Canada and beyond.

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Decreased Colorectal Cancer Incidence and Incidence-Based Mortality in the Screening-Age Population of Ontario

Cited by 3 publications

References 21 publications

Effect of Chronic Comorbidities on Follow-up Colonoscopy After Positive Colorectal Cancer Screening Results: A Population-Based Cohort Study

Effect of Chronic Comorbidities on Follow-up Colonoscopy After Positive Colorectal Cancer Screening Results: A Population-Based Cohort Study

Impact of organised colorectal cancer screening on age-specific population incidences: evidence from a quasi-experimental study in Sweden

Development of a National Colorectal Cancer Screening Research Agenda: An Initiative of the Canadian Screening for Colorectal Cancer Research Network (CanSCCRN)

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