Mass screening for colorectal cancer: compliance in Almopea Region

Abstract

Colorectal cancer (CRC) is the second leading cause of cancer-related morbidity and mortality in Europe and the United States. Planning for a CRC screening began in co-operation with local authorities (Pella Prefecture sponsored test kits). Our aims were to develop a screening programme for colorectal cancer using the faecal occult blood test (FOBT) in Almopea province, and to investigate the compliance of local farmers population. Cancer statistics data from Almopea have been analysed and they showed higher colorectal cancer incidence compared to the rest of Greece. We designed a one-time FOBT screening programme on the Surgery Department computer Network, in which we listed 8963 subjects, over 50 years of age. From them, 4189 underwent 3 days FOBT, and the rest were our control group. The method of successive visits to each community by the medical team and educational meeting was chosen. For allocation and gathering of tests, teams of volunteers have been organised. In case of positive FOBT (176 subjects), total colonoscopy was performed. Seventeen (17) polypoids (in 15 patients) and 20 cases of diverticulosis were detected. The compliance of FOBT group was 49% (from 4189). Colonoscopy accepted 89% from 176 patients with positive test. We concluded that our study shows poor compliance of screening population. There is a need for co-operation of medical services, local authorities, media and volunteers support organising.

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

“…Participants in the group on which diagnostic or therapeutic colonoscopy 4 has been performed to follow-up primary screening according to programme policy include participants, the screening endoscopy of which was inadequate or incomplete. Note that each person is counted once regardless of the number of followup colonoscopies that were performed.…”

“…In rare cases in which follow-up colonoscopy is not possible, other followup examinations may be performed. Those patients should be included in the group referred to follow-up CS but should also be counted separately 4. See previous footnote on follow-up colonoscopy 5.…”