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What is the impact and success of colorectal cancer screening in regional Victoria?: https://share.medall.org/posters/d8f5ed5b-1e74-495c-a59f- 2826e15593b4
Poster · July 2021
DOI: 10.13140/RG.2.2.18835.40485
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Impact and success of colorectal cancer screening in regional VictoriaView project Vanessa Balo
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Methods
• We identified the number of patients who underwent colonoscopy due to a positive result from a FOBT screening test over the first six months of 2016 in the practice of one specialist colorectal surgeon in regional Victoria. Patients who underwent colonoscopy due to other indications such as personal or family history of CRC were excluded.
• We then examined histopathological records to calculate the number of FOBT-indicated coloscopies that resulted in significant findings.
These were defined as either: cancerous lesions, serrated adenomas or adenomatous polyp measuring greater than or equal to 1 cm in length.
Hyperplastic polyps were not included in this count since they are considered to pose little to no risk of colorectal malignancy. 5
• Following this, we kept note of how many of these patients had already developed colorectal cancer.
What is the impact and success of colorectal cancer screening in regional Victoria?
VANESSA B. BALO, BRUCE STEWART
1Colorectal Surgical Unit, Ballarat Health Services; 2University of Melbourne
References
1. Australian Institute of Health and Welfare. (2021). Cancer data in Australia.
Retrieved from https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia 2. Hewitson, P., Glasziou, P., Watson, E., Towler, B., & Irwig, L. (2008). Cochrane
systematic review of colorectal cancer screening using the fecal occult blood test (hemoccult): an update. American Journal of Gastroenterology, 103(6), 1541-1549.
3. Lew, J. B., St John, D. J. B., Xu, X. M., Greuter, M. J., Caruana, M., Cenin, D.
R., & Canfell, K. (2017). Long-term evaluation of benefits, harms, and cost- effectiveness of the National Bowel Cancer Screening Program in Australia: a modelling study. The Lancet Public Health, 2(7), 331-340.
4. Australian Government Department of Health. (2019). National Bowel Cancer Screening Program. Canberra: Australian Government Department of Health.
Retrieved from:
https://www.health.gov.au/initiatives-and-programs/national-bowel-cancer- screening-program/about-the-national-bowel-cancer-screening-program
5. Goldman, H. (1970). Nature and significance of hyperplastic polyps of the human colon. Arch Pathology, 89, 349-354.
Results
• Over the six months, a total of 477 patients underwent colonoscopies.
• Of these patients, 63 (13%) underwent a colonoscopy due to a positive FOBT result.
• Of these, 29 patients (46.8%) had significant findings and 3 (4.8%) of them had bowel cancer.
• Our data provides further evidence of the evolving success that FOBT screening has had in early identification of CRC and high-risk polyps in an Australian community.
Colonoscopies due to positive FOBT
result, 105 Colonoscopies which
identified high risk lesions, 47
Colonoscopies which identified cancerous lesions, 3
0 20 40 60 80 100 120
Impact of colorectal cancer screening in regional Victoria
Study objectives
• To assess the impact of FOBT screening on a community-based colonoscopy service.
• Assess the success of this screening program at identifying patients with significant colonic pathology in a regional Victorian setting.
Colonoscopy images reproduced with permission from Dr. B. Stewart.
Background
E: [email protected] @balo_vanessa
• Colorectal Cancer (CRC) is the second most common cause of cancer related deaths in Australia. 1
• Faecal Occult Blood Test (FOBT) screening can identify patients at an early stage of CRC where curative treatment may still be achievable. 2
• Long-term cohort follow up studies have demonstrated an overall reduction in bowel cancer incidence and mortality due to FOBT screening measures. 3
• A nationalised CRC screening program was first established in Australia in 2006 which offered free immunochemical FOBT for Australians turning 55 years and 65 years in that year.
• More than 90% of CRC diagnoses are in the 50+ age group. 3 Thus, the program was expanded in 2012 to biennial CRC screening of all Australians between 50 and 74 years of age. 4
• Following a positive FOBT result, further investigations such as colonoscopy with histology of any excised lesions, helps to identify any high-risk lesions present.
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