European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition – Evaluation and interpretation of screening outcomes

Moss, Susan; Ancelle-Park, R.; Brenner, Hermann

doi:10.1055/s-0032-1309788

Cited by 69 publications

(99 citation statements)

References 22 publications

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“…Each article covers one of the 10 chapters of the guidelines [3,[16][17][18][19][20][21][22][23][24], the annex of the chapter dealing with quality assurance in pathology [25], the section on principles of evidence assessment and methods for reaching recommendations [28], or the executive summary [26]. The results section of each chapter article begins with a list of key recommendations with a dual grading showing the strength of each recommendation and the supporting evidence.…”

Section: Author Manuscript Author Manuscriptmentioning

confidence: 99%

“…Personal invitation aims to give each eligible person an equal chance of benefiting from screening and thereby reduce health inequalities. As with evidence-based screening for breast or cervical cancer, the population-based approach to programme implementation is also recommended for CRC screening because it provides an organizational framework conducive to effective management and continuous improvement of the screening process, such as through linkage with population and cancer registries for optimization of invitation to screening and for evaluation of screening performance and impact [3,[13][14][15][16][17]. Nationwide implementation of population-based screening programmes makes services performing to high standards available to the entire population eligible to attend screening.…”

Section: Author Manuscriptmentioning

confidence: 99%

“…The third chapter contains 20 graded recommendations on the processes and procedures required for effective monitoring and evaluation of CRC screening programmes [17]. Of fundamental importance is the complete and accurate recording of all relevant data on each individual and every screening test performed.…”

Section: Evaluation and Interpretation Of Screening Outcomesmentioning

confidence: 99%

“…Comprehensive European quality assurance guidelines for breast and cervical cancer screening have been developed by experts and published by the EU [14,15]. The new European guidelines for quality assurance in colorectal cancer screening and diagnosis [3,[16][17][18][19][20][21][22][23][24][25][26][27]] make similar principles, standards and recommendations available to healthcare professionals, scientists, decision-makers and other stakeholders seeking to establish or improve CRC screening programmes.The content of the evidence-based multidisciplinary guidelines is presented in 13 articles in a recent Supplement to Endoscopy. Each article covers one of the 10 chapters of the guidelines [3,[16][17][18][19][20][21][22][23][24], the annex of the chapter dealing with quality assurance in pathology [25], the section on principles of evidence assessment and methods for reaching recommendations [28], or the executive summary [26].…”

mentioning

confidence: 99%

“…The new European guidelines for quality assurance in colorectal cancer screening and diagnosis [3,[16][17][18][19][20][21][22][23][24][25][26][27]] make similar principles, standards and recommendations available to healthcare professionals, scientists, decision-makers and other stakeholders seeking to establish or improve CRC screening programmes.…”

mentioning

confidence: 99%

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European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

Karsa¹,

Patnick²,

Segnan³

et al. 2012

Endoscopy

250

187

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Population-based screening for early detection and treatment of colorectal cancer (CRC) and precursor lesions, using evidence-based methods, can be effective in populations with a significant burden of the disease provided the services are of high quality. Multidisciplinary, evidence-based guidelines for quality assurance in CRC screening and diagnosis have been developed by experts in a project co-financed by the European Union. The 450-page guidelines were published in book format by the European Commission in 2010.They include 10 chapters and over 250 recommendations, individually graded according to the strength of the recommendation and the supporting evidence. Adoption of the recommendations can improve and maintain the quality and effectiveness of an entire screening process, including identification and invitation of the target population, diagnosis and management of the disease and appropriate surveillance in people with detected lesions. To make the principles, recommendations and standards in the guidelines known to a wider professional and scientific community and to facilitate their use in the scientific literature, the original content is presented in journal format in an open-access Supplement of Endoscopy. The editors have prepared the present overview to inform readers of the comprehensive scope and content of the guidelines. IntroductionAccording to recent estimates by the International Agency for Research on Cancer [1], colorectal cancer (CRC) is the most common cancer in Europe with 432 000 new cases reported annually in men and women combined. It is the second most common cause of cancer deaths in Europe with 212 000 deaths reported in 2008.Worldwide, CRC ranks third in incidence and fourth in mortality with an estimated 1.2 million cases and 0.6 million deaths annually. In the 27 Member States of the European Union (EU), CRC ranks first in incidence and second in mortality, with approximately 334000 new cases and 149000 deaths estimated in 2008.Even in those Member States in the lower range for age-standardized rates of CRC, the burden of disease is significantly greater when compared with many other HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript regions of the world (see reference [1]). CRC is therefore an important health problem across the EU.Screening can be effective in cancer control in populations with a significant burden of CRC, provided the services are of high quality [2]. The aim of CRC screening is to lower the burden of cancer in the population by discovering disease in its early, latent stages [3]. Evidence-based methods permit treatment that is more effective than if disease is diagnosed later when symptoms have occurred. Early treatment of invasive lesions, for example by endoscopic resection of early CRC, can also be less detrimental for quality of life. The endoscopic removal of pre-malignant lesions also reduces the incidence of CRC by avoiding the progression to cancer. Randomized trials in people of average risk invite...

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Section: Author Manuscript Author Manuscriptmentioning

confidence: 99%

Section: Author Manuscriptmentioning

confidence: 99%

Section: Evaluation and Interpretation Of Screening Outcomesmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

Karsa¹,

Patnick²,

Segnan³

et al. 2012

Endoscopy

250

187

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Pandemic‐resilient target setting in colorectal cancer screening for vulnerable older population

et al. 2022

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Background Colorectal cancer screening (CRCS) needs to be pandemic‐resilient to avoid long‐lasting shutdowns; however, realistic participation target remains unelucidated. This study aimed to identify the lowest acceptable participation rate in CRCS during a pandemic, focusing on vulnerable older populations who require urgent intervention. Methods This nationwide cross‐sectional study included 80,946 inpatients aged 70–85 years who were first diagnosed with colorectal cancer (CRC) after 70 years of age, between April 1, 2014 and March 31, 2019, in Japan. To evaluate the association between area‐level CRCS participation rate and individual early CRC detection, a multilevel logistic regression model was constructed. The mandatorily implemented screening rates were converted to the total screening rate equivalents (TSREs), which reflect the remaining contributions of voluntarily provided screenings. Results Early detections during stages 0–I were significantly observed when primary screening rate was ≥38% (TSRE) and combined follow‐up rate was ≥85%. For early detection during Tis–T1, primary screening rate ≥ 38% (TSRE) and combined follow‐up rate ≥ 90% were necessary. For follow‐up rates ≥70% or ≥75%, there were cases where missed detection of Tis–T1 were observed. Conclusion The results indicate that, even during pandemic, CRCS should achieve a primary screening rate of 38% and follow‐up rate of 85% for vulnerable older populations. These values, lower than the current desirable rates, suggest the maximum possible compromise in balancing the resources between cancer screening and pandemic measures. Moreover, they also indicate the minimum target for shifting to fecal immunochemical test‐focused program. Further explorations with varied CRCS settings are necessary for verification.

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Factors associated with interval colorectal cancer after negative FIT: Results of two screening rounds in the Dutch FIT‐based CRC screening program

Breekveldt

Toes‐Zoutendijk

Schootbrugge-Vandermeer

et al. 2022

Intl Journal of Cancer

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The interval colorectal cancer (CRC) rate after negative fecal immunochemical testing (FIT) is an important quality indicator of CRC screening programs. We analyzed the outcomes of two rounds of the FIT-based CRC screening program in the Netherlands, using data from individuals who participated in FIT-screening from 2014 to 2017. Data of individuals with one prior negative FIT (first round) or two prior negative FITs (first and second round) were included. Outcomes included the incidence of interval CRC in FIT-negative participants (<47 μg Hb/g feces [μg/g]), FIT-sensitivity, and the probability of detecting an interval CRC by fecal hemoglobin concentration (f-Hb). FIT-sensitivity was estimated using the detection method and the proportional incidence method (based on expected CRC incidence). Logistic regression analysis was performed to estimate whether f-Hb affects probability of detecting interval CRC, adjusted for sex-and age-differences. Incidence of interval CRC was 10.4 per 10 000 participants after the first and 9.6 after the second screening round. FIT-sensitivity based on the detection method was 84.4% (95%CI 83.8-85.0) in the first and 73.5% (95% CI 71.8-75.2) in the second screening round.The proportional incidence method resulted in a FIT-sensitivity of 76.4% ) in the first and 79.1% (95%CI 73.7-85.3) in the second screening round.After one negative FIT, participants with f-Hb just below the cut-off (>40-46.9 μg/g) had a higher probability of detecting an interval CRC (OR 16.9; 95%CI: 14.0-20.4) than had participants with unmeasurable f-Hb (0-2.6 μg/g). After two screening rounds, the odds ratio for interval CRC was 12.

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European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition – Evaluation and interpretation of screening outcomes

Abstract: • " mass screening • " colorectal neoplasms • " evaluation • " monitoring • " screening outcomes • " evidence-based guidelines • " population-based programmes Bibliography

Cited by 69 publications

References 22 publications

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

Pandemic‐resilient target setting in colorectal cancer screening for vulnerable older population

Factors associated with interval colorectal cancer after negative FIT: Results of two screening rounds in the Dutch FIT‐based CRC screening program

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