Carrie Klabunde1, Johannes Blom2, Jean-Luc Bulliard3, Montse Garcia4, Lea Hagoel5, Verna Mai6, Julietta Patnick7, Heather Rozjabek8, Carlo Senore9, Sven Törnberg10. 1. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA. 2. Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden johannes.blom@ki.se. 3. Institute of Social and Preventive Medicine, Division of Chronic Diseases, Lausanne University Hospital, Lausanne, Switzerland. 4. Cancer Prevention and Control Program, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain. 5. Department of Community Medicine and Epidemiology, The Faculty of Medicine, Technion, and Carmel Medical Center Haifa, Israel. 6. Canadian Partnership Against Cancer, Toronto, Canada. 7. NHS Cancer Screening Programmes, Public Health England, Sheffield, UK. 8. Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA. 9. Centro di Prevenzione Oncologica Piemonte, AOU Città della Salute e della Scienza, Turin, Italy. 10. Department of Oncology-Pathology, Karolinska Institutet and Regional Cancer Centre Stockholm Gotland, Sweden.
Abstract
OBJECTIVE: Participation, an indicator of screening programme acceptance and effectiveness, varies widely in clinical trials and population-based colorectal cancer (CRC) screening programmes. We aimed to assess whether CRC screening participation rates can be compared across organized guaiac fecal occult blood test (G-FOBT)/fecal immunochemical test (FIT)-based programmes, and what factors influence these rates. METHODS: Programme representatives from countries participating in the International Cancer Screening Network were surveyed to describe their G-FOBT/FIT-based CRC screening programmes, how screening participation is defined and measured, and to provide participation data for their most recent completed screening round. RESULTS: Information was obtained from 15 programmes in 12 countries. Programmes varied in size, reach, maturity, target age groups, exclusions, type of test kit, method of providing test kits and use, and frequency of reminders. Coverage by invitation ranged from 30-100%, coverage by the screening programme from 7-67.7%, overall uptake/participation rate from 7-67.7%, and first invitation participation from 7-64.3%. Participation rates generally increased with age and were higher among women than men and for subsequent compared with first invitation participation. CONCLUSION: Comparisons among CRC screening programmes should be made cautiously, given differences in organization, target populations, and interpretation of indicators. More meaningful comparisons are possible if rates are calculated across a uniform age range, by gender, and separately for people invited for the first time vs. previously.
OBJECTIVE: Participation, an indicator of screening programme acceptance and effectiveness, varies widely in clinical trials and population-based colorectal cancer (CRC) screening programmes. We aimed to assess whether CRC screening participation rates can be compared across organized guaiac fecal occult blood test (G-FOBT)/fecal immunochemical test (FIT)-based programmes, and what factors influence these rates. METHODS: Programme representatives from countries participating in the International Cancer Screening Network were surveyed to describe their G-FOBT/FIT-based CRC screening programmes, how screening participation is defined and measured, and to provide participation data for their most recent completed screening round. RESULTS: Information was obtained from 15 programmes in 12 countries. Programmes varied in size, reach, maturity, target age groups, exclusions, type of test kit, method of providing test kits and use, and frequency of reminders. Coverage by invitation ranged from 30-100%, coverage by the screening programme from 7-67.7%, overall uptake/participation rate from 7-67.7%, and first invitation participation from 7-64.3%. Participation rates generally increased with age and were higher among women than men and for subsequent compared with first invitation participation. CONCLUSION: Comparisons among CRC screening programmes should be made cautiously, given differences in organization, target populations, and interpretation of indicators. More meaningful comparisons are possible if rates are calculated across a uniform age range, by gender, and separately for people invited for the first time vs. previously.
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