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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2018; 72(5): 379–384. doi:10.14735/amgh2018379.

Evaluation of colorectal cancer screening centers in the Czech Republic

Ondřej Ngo1,2, Barbora Bučková2, Štěpán Suchánek Orcid.org  3, Miroslav Zavoral Orcid.org  3, Ladislav Dušek Orcid.org  1,4, Ondřej Májek Orcid.org  4

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Summary

Backgrounds: The Czech republic has a leading position in the incidence and mortality of colorectal cancer compared to other European countries. Screening programs are an essential part of prevention policies in the Czech Republic. The success of these programs depend on the continuous monitoring of the screening process. The aim of the paper is to evaluate the performance of preventive colonoscopies performed in the Czech Republic in accordance with established recommendations. Material and Methods: Data on preventive colonoscopies performed in centers for screening colonoscopy (Centers), which are collected in a central database, were used to evaluate key performance indicators, including cecal intubation rate, detection rate of screening colonoscopy, and positive predictive value (PPV) of fecal occult blood test (FOBT). Performance indicators were evaluated in accordance with the published recommendations of the Czech Gastroenterological Society. Results: About 25% of centers did not achieve the desirable cecal intubation rate (95%), but most of these reached at least the minimally acceptable rate of 90%. The reference value of the proportion of detected adenoma was met in most Centers (93%), but high variability was observed across Centers (10.2–74.8%). A similar situation was observed within evaluation by gender and indication. In particular, low PPV of FOBT may be associated with high FOBT positivity and possibly unnecessary colonoscopies. Conclusion: Some Centers did not reach the reference values of the performance indicators, especially the cecal intubation rate. Limited FOBT PPV observed in some centers shows that there is room for program improvement. Efforts should be made to formulate and implement actions to optimize the program at the level of participating Centers.

Keywords

performance indicators, colorectal cancer, colonoscopy, mass screening

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Literature

1. Ferlay J, Soerjomataram I, Dikshit R et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136 (5): E359–E386. doi: 10.1002/ijc.29210.
2. Dušek L, Mužík J, Malúšková D et al. Epidemiologie zhoubných nádorů cílených screeningem dle nových dat Národního onkologického registru České republiky. Klin Onkol 2014; 27 (Suppl 2): 2S19–2S39.
3. Kim PJ, Plescia J, Clevers H et al. Survivin and molecular pathogenesis of colorectal cancer. Lancet 2003; 362 (9379): 205–209. doi: 10.1016/S0140-6736 (03) 13910-4.
4. Wild C, Stewart BW (eds). World Cancer Report 2014. Lyon: International Agency for Research on Cancer 2014 [online]. Dostupné z: https: //www.drugsandalcohol.ie/28525/1/World%20Cancer %20Report.pdf.
5. European Council. Council Recommendation of 2nd December 2003 on cancer screening. [online]. Available from: http: //eurlex.europa.eu/ LexUriServ/LexUriServ.do?uri=OJ: L: 2003: 327:  0034: 0038: EN: PDF.
6. Zavoral M, Suchanek S, Zavada F et al. Colorectal cancer screening in Europe. World J Gastroenterol 2009; 15 (47): 5907–5915.
7. Ponti A, Anttila A, Ronco G et al. Cancer screening in the European Union (2017), report of the implementation of the Council Recommendation on Cancer Screening.
8. Suchanek S, Majek O, Vojtechova G et al. Colorectal cancer prevention in the Czech Republic: time trends in performance indicators and current situation after 10 years of screening. Eur J Cancer Prev 2014; 23 (1): 18–26. doi: 10.1097/CEJ.0b013e328364f203.
9. van Rossum LG, van Rijn AF, Laheij RJ et al. Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population. Gastroenterology 2008; 135 (1): 82–90. doi: 10.1053/j.gastro.2008.03.040.
10. Grega T, Májek O, Ngo O et al. Současné principy screeningu kolorektálního karcinomu – od oportunního k populačnímu screeningovému programu. Gastroent Hepatol 2016; 70 (5): 383–392. doi: 10.14735/amgh2016383.
11. Zavoral M, Vojtěchová G, Májek O et al. Population colorectal cancer screening in the Czech Republic. Cas Lek Cesk 2016; 155 (1): 7–12.
12. Dušek L, Májek O, Blaha M et al. Koncepce populačního screeningu v České republice, metodika a první výsledky adresného zvaní občanů do preventivních onkologických programů. Klin Onkol 2014; 27 (Suppl 2): 2S59–2S68. doi: 10.14735/amko20142S59.
13. Segnan N, Patnick J, von Karsa L (eds). European guidelines for quality assurance in colorectal cancer screening and diagnosis. 1st ed. Luxembourg: Publications Office ot the European Union 2010.
14. Falt P, Urban O, Suchánek Š et al. Doporučené postupy České gastroenterologické společnosti ČLS JEP pro diagnostickou a terapeutickou koloskopii. Gastroent Hepatol 2016; 70 (6): 523–538. doi: 10.14735/amgh2016csgh.info19.
15. OECD. Survival and mortality for colorectal cancer. Health at a Glance 2015: 154–155.
16. Dušek L, Májek O, Mužík J et al. Epidemiologie a populační screening nádorů tlustého střeva a konečníku v ČR na podkladě nově dostupných dat. Gastroent Hepatol 2015; 69 (6): 509–517. doi: 10.14735/amgh2015509.
17. Ngo O, Bučková B, Suchánek Š et al. Účast české populace na screeningu kolorektálního karcinomu – vývoj a aktuální stav. Gastroent Hepatol 2017; 71 (5): 377–383. doi: 10.14735/amgh2017377.
18. Malila N, Oivanen T, Malminiemi O et al. Test, episode, and programme sensitivities of screening for colorectal cancer as a public health policy in Finland: experimental design. Br Med J 2008; 337: a2261. doi: 10.1136/bmj.a2261.
19. Zavoral M, Suchanek S, Majek O et al. Colorectal cancer screening: 20 years of development and recent progress. World J Gastroenterol 2014; 20 (14): 3825–3834. doi: 10.3748/wjg.v20.i14.3825.

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