Dataset Information

The Impact of a Six-Year Existing Screening Programme Using the Faecal Immunochemical Test in Flanders (Belgium) on Colorectal Cancer Incidence, Mortality and Survival: A Population-Based Study.

ABSTRACT: The faecal immunochemical test (FIT) has been increasingly used for organised colorectal cancer (CRC) screening. We assessed the impact of a six-year existing FIT screening programme in Flanders (Belgium) on CRC incidence, mortality and survival. The Flemish CRC screening programme started in 2013, targeting individuals aged 50-74 years. Joinpoint regression was used to investigate trends of age-standardised CRC incidence and mortality among individuals aged 50-79 years (2004-2019). Their 5-year relative survival was calculated using the Ederer II method. We found that FIT screening significantly reduced CRC incidence, especially that of advanced-stage CRCs (69.8/100,000 in 2012 vs. 51.1/100,000 in 2019), with a greater impact in men. Mortality started to decline in men two years after organised screening implementation (annual reduction of 9.3% after 2015 vs. 2.2% before 2015). The 5-year relative survival was significantly higher in screen-detected (93.8%) and lower in FIT non-participant CRCs (61.9%) vs. FIT interval cancers and CRCs in never-invited cases (67.6% and 66.7%, respectively). Organised FIT screening in Flanders clearly reduced CRC incidence (especially advanced-stage) and mortality (in men, but not yet in women). Survival is significantly better in screen-detected cases vs. CRCs in unscreened people. Our findings support the implementation of FIT organised screening and the continued effort to increase uptake.

SUBMITTER: Tran TN

PROVIDER: S-EPMC9864341 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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The Impact of a Six-Year Existing Screening Programme Using the Faecal Immunochemical Test in Flanders (Belgium) on Colorectal Cancer Incidence, Mortality and Survival: A Population-Based Study.

Tran Thuy Ngan TN Hoeck Sarah S De Schutter Harlinde H Janssens Sharon S Peeters Marc M Van Hal Guido G

International journal of environmental research and public health 20230116 2

The faecal immunochemical test (FIT) has been increasingly used for organised colorectal cancer (CRC) screening. We assessed the impact of a six-year existing FIT screening programme in Flanders (Belgium) on CRC incidence, mortality and survival. The Flemish CRC screening programme started in 2013, targeting individuals aged 50-74 years. Joinpoint regression was used to investigate trends of age-standardised CRC incidence and mortality among individuals aged 50-79 years (2004-2019). Their 5-year ...[more]

PMID: 36674409

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Project description:ObjectivesThrough the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP), men and women in England aged between 60 and 74 years are invited for colorectal cancer (CRC) screening every 2 years using the guaiac faecal occult blood test (gFOBT). The aim of this analysis was to estimate the cost-utility of the faecal immunochemical test for haemoglobin (FIT) compared with gFOBT for a cohort beginning screening aged 60 years at a range of FIT positivity thresholds.DesignWe constructed a cohort-based Markov state transition model of CRC disease progression and screening. Screening uptake, detection, adverse event, mortality and cost data were taken from BCSP data and national sources, including a recent large pilot study of FIT screening in the BCSP.ResultsOur results suggest that FIT is cost-effective compared with gFOBT at all thresholds, resulting in cost savings and quality-adjusted life years (QALYs) gained over a lifetime time horizon. FIT was cost-saving (p<0.001) and resulted in QALY gains of 0.014 (95% CI 0.012 to 0.017) at the base case threshold of 180 µg Hb/g faeces. Greater health gains and cost savings were achieved as the FIT threshold was decreased due to savings in cancer management costs. However, at lower thresholds, FIT was also associated with more colonoscopies (increasing from 32 additional colonoscopies per 1000 people invited for screening for FIT 180 µg Hb/g faeces to 421 additional colonoscopies per 1000 people invited for screening for FIT 20 µg Hb/g faeces over a 40-year time horizon). Parameter uncertainty had limited impact on the conclusions.ConclusionsThis is the first published economic analysis of FIT screening in England using data directly comparing FIT with gFOBT in the NHS BSCP. These results for a cohort starting screening aged 60 years suggest that FIT is highly cost-effective at all thresholds considered. Further modelling is needed to estimate economic outcomes for screening across all age cohorts simultaneously.

Project description:"Watervogels - Wintering waterbirds in Flanders, Belgium" is a sampling event dataset published by the Research Institute for Nature and Forest (INBO). It contains more than 94,000 sampling events (site counts), covering over 710,000 species observations (and zero counts when there is no associated occurrence) and 36 million individual birds for the period 1991-2016. The dataset includes information on 167 different species in nearly 1,100 wetland sites. The aim of these bird counts is to gather information on the size, distribution, and long-term trends of wintering waterbird populations in Flanders. These data are also used to assess the importance of individual sites for waterbirds, using quantitative criteria. Furthermore, the waterbird counts contribute to international monitoring programs, such as the International Waterbird Census (coordinated by Wetlands International) and fulfil some of the objectives of the European Bird Directive, the Ramsar Convention, and the Agreement on the Conservation of African-Eurasian Migratory Waterbirds (AEWA). Here the dataset is published as a standardized Darwin Core Archive and includes for each event: a stable event ID, date and location of observation and a short description of the sampling protocol, effort and conditions (in the event core), supplemented with specific information for each occurrence: a stable occurrence ID, the scientific name and higher classification of the observed species, the number of recorded individuals, and a reference to the observer of the record (in the occurrence extension). Issues with the dataset can be reported at https://github.com/inbo/data-publication/issues. The following information is not included in this dataset and available upon request: roost site counts, counts from historical (inactive) locations and counts from before 1991. We have released this dataset to the public domain under a CC0 1.0 Universal (CC0 1.0) Public Domain Dedication (https://creativecommons.org/publicdomain/zero/1.0/). We would appreciate it if you follow the INBO norms for data use (https://www.inbo.be/en/norms-data-use) when using the data. If you have any questions regarding this dataset, do not hesitate to contact us via the contact information provided in the metadata or via opendata@inbo.be.

Dataset Information

The Impact of a Six-Year Existing Screening Programme Using the Faecal Immunochemical Test in Flanders (Belgium) on Colorectal Cancer Incidence, Mortality and Survival: A Population-Based Study.

Publications

The Impact of a Six-Year Existing Screening Programme Using the Faecal Immunochemical Test in Flanders (Belgium) on Colorectal Cancer Incidence, Mortality and Survival: A Population-Based Study.

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