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Colorectal Cancer Screening: Overview of Existing Programs

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Colorectal Cancer Screening: Overview of Existing Programs

Methods


For this review, national and international guidelines on CRC screening were evaluated. We collected information on CRC screening programme characteristics from guidelines, through national governmental websites and international contact persons including public health researchers, those responsible for the development and implementation of screening programmes and participants of the Colorectal Cancer Screening Committee of the World Endoscopy Organisation. A literature search in PUBMED and The Cochrane Central Register of Controlled Trials was performed using the following keywords: CRC screening, guidelines, Europe/America/Canada/Asia/Australia/New Zealand, RCTs, colonoscopy, guaiac faecal occult blood test (gFOBT), faecal immunochemical test for haemoglobin (FIT), flexible sigmoidoscopy (FS), CT colonography (CTC), DNA-marker and video capsule endoscopy. To evaluate and compare screening programmes, we used the universally applicable CRC screening indicators established by the International Colorectal Cancer Screening Network based on the criteria of the International Agency for Research on Cancer (IARC). To report screening indicators regarding FIT screening, the Faecal Immunochemical TesTs for haemoglobin Evaluation Reporting guidelines were followed. We used the recommended reporting units of microgram haemoglobin per gram faeces (μg Hb/g) rather than nanogram haemoglobin per millilitre buffer (ng Hb/mL) to ensure comparability of results. The term 'average risk population' used in this review refers to an asymptomatic population who is at average risk for CRC. The age range of this population is influenced by national guidelines and varies per study but is mainly over age 50 years and constantly over age 40 years. For the overview of current status of screening programmes, at least the top 10 countries with highest age-ASRi for each world continent were included.

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