title: Faecal immunochemical test-based colorectal cancer screening programme SVIT in Slovenia: pilot phase.
abstract: Colorectal cancer (CRC) is the second most common cancer in Slovenia. The 5-year survival of patients depends on the clinical stage at presentation. More than 70% of patients with CRC are diagnosed as being in stage III or IV, with a 5-year survival rate of 52.7%. To improve the detection rate of CRC and to detect CRC in its early and more curable stage, a national screening programme is needed. In the year 2008, we started a pilot phase of the National CRC screening programme. We invited 9091 Slovene residents aged 64-68 years from Ljubljana, Kranj, and Celje regions, of whom 3807 responded to our invitation (41.9%). Two kits of the faecal immune test were sent to 3117 participants who met the inclusion criteria, and 2829 (90.7%) tests were returned. The compliance rate in our pilot programme was 32.9%. Among the patients who responded positively, 7.5% were positive. Until February 2009, 193 colonoscopies had been performed at DC Bled, DC Lipa and AM DC Rogaška. Intubation to the caecum was carried out in 99.4% of colonoscopies. Histology specimens were taken from 135 patients (70%). The adenoma detection rate was 53.8% (59.8% for men and 47.9% for women; P<0.05). We detected 1-17 adenomas per patient (2.4 on average). Advanced adenomas were detected in 60 patients (31%; 35.1% of men and 27.1% of women; P<0.05). Invasive carcinoma was detected in 15 patients (7.7%; 12.4% of men and 3.1% of women; P<0.05). Ten of them (73.3%) were in clinical stage I or II. In the pilot phase of the CRC screening programme the majority of CRCs were detected at early clinical stages. Invasive cancers were detected in 7.7% of patients. In almost all patients adenomas were resected at screening colonoscopy, thus reducing the possibility of later development of CRC in those patients.
authors.affiliation: aAM DC Rogaska, Rogaška Slatina bDepartment of Gastroenterology, University Clinical Center cDepartment of Pathology, Institute for Oncology dSVIT, National Institute of Public Health, Ljubljana eDC Bled, Bled, Slovenia.
authors.forename: Bojan
authors.initials: B
authors.lastname: Tepeš
authors.forename: Borut
authors.initials: B
authors.lastname: Stabuc
authors.forename: Milan
authors.initials: M
authors.lastname: Stefanovič
authors.forename: Matej
authors.initials: M
authors.lastname: Bračko
authors.forename: Snežana
authors.initials: S
authors.lastname: Frkovič Grazio
authors.forename: Dominika
authors.initials: D
authors.lastname: Novak Mlakar
authors.forename: Jožica
authors.initials: J
authors.lastname: Maučec Zakotnik
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D007120:Immunochemistry; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D010865:Pilot Projects; D017524:Slovenia