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The impact of six years of the National Colorectal Cancer Screening Program on colorectal cancer incidence and five year survival

Bojan Tepeš1, Dominika Novak Mlakar2, Milan Stefanovič3, Borut Štabuc4, Snježana Frkovič Grazio4, Jožica Maučec Zakotnik3

Figure 2. Invitation proces of the National Colorectal cancer screening - flow diagram

Table 7. Cancer distribution in colon in three screening rounds (ICD 10)

First round Second round Third round

Location Number Percent Number Percent Number Percent

C180 (cecum) 41 4.8 26 5.5 20 4.9

C182 (ascendent) 54 6.3 29 6.2 33 8.1

C183 (hepatic flexure ) 20 2.3 16 3.4 18 4.4

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C184 (transverse) 18 2.1 21 4.5 12 3

C185 (splenic flexure) 28 3.2 14 3.0 12 3

C186 (descendent ) 40 4.6 10 2.1 11 2.7

C187 (sigmoid) 351 40.7 160 34.1 118 29.1

C19 (recto sigmoid ) 88 10.3 33 7.0 30 7.4

C20 (rectum) 222 25.7 160 34.2 151 37.3

Total 862 100.0 469 100.0 405 100

Table 8. Prevalence rate for cancer and precancerous lesions ‒ first round of screening

* significant difference Legend:

Prevalence ratio for cancer and 95

% CI

p value Prevalence ratio for advanced adenoma and 95

% CI

p value Prevalence ratio for adenoma and 95 % CI

p value

sex

men 1.00 1.00 1.00

women 0.86 [0.74– 0.99] 0.031* 0.69 [0.65 – 0.74] < 0.0001* 0.86 [0.77 – 0.95] 0.002*

Age groups (years)

50 - 54 1.00 1.00 1.00

55 - 59 1.35 [1.08 – 1.69] 0.008* 1.16 [1.07 – 1.26] < 0.0001* 0.97 [0.84 – 1.11] 0.615 60 - 64 1.43 [1.15 – 1.76] 0.001* 1.19 [1.10 – 1.29] < 0.0001* 0.96 [0.84 – 1.10] 0.580 65 + 2.40 [1.82 – 2.76] < 0.0001* 1.20 [1.10 – 1.31] < 0.0001* 0.95 [0.82 – 1.09] 0.438

Family history 1

yes 1.33 [0.89 – 1.96] 0.158 1.15 [0.97 – 1.36] 0.118 0.59 [0.39 – 0.89] 0.012*

no 1.00 1.00 1.00

Family history 2

yes 1.11 [0.83 – 1.48] 0.497 1.05 [0.93 – 1.19] 0.395 0.89 [0.71 – 1.12] 0.324

no 1.00 1.00 1.00

Acetylsalicylic acid use

yes 0.66 [0.51 – 0.86] 0.002* 0.82 [0.74 – 0.91] < 0.0001* 1.10 [0.94 – 1.29] 0.226

ne 1.00 1.00 1.00

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Family history 1 ‒ first grade relative with colorectal cancer < 60 years of age

Family history 2 ‒ first grade relative with colorectal cancer > 60 years of age or >=2 second grade relatives with colorectal cancer

Acetylsalicylic acid – regular intake of the drug

Table 9. Prevalence ratio for cancer and precancerous lesions ‒ second round of screening

*

significant difference Legend:

Family history 1 ‒ first grade relative with colorectal cancer < 60 years of age

Family history 2 ‒ first grade relative with colorectal cancer > 60 years of age or >=2 second grade relatives with colorectal cancer

Prevalence ratio for cancer and 95%

CI

p value Prevalence ratio for advanced adenoma and 95% CI

p value Prevalence ratio for adenoma and 95% CI

p value

SEX

men 1.00 1.00 1.00

women 0.86 [0.71– 1.04] 0.114 0.65 [0.61 – 0.70] < 0.0001* 0.84 [0.77 – 0.91] < 0.0001*

Age groups (years)

50- 54 1.00 1.00 1.00

55 - 59

1.34 [0.99 – 1.82] 0.061 1.06 [0.97 – 1.16] 0.180 1.08 [1.04 – 1.32] 0.008*

60 - 64

1.71 [1.31 – 2.25] < 0.0001* 1.15 [1.06 – 1.25] 0.001* 1.10 [0.97 – 1.22] 0.059 65 + 2.25 [1.69 – 3.01] < 0.0001* 1.18 [1.07 – 1.29] 0.001* 1.17 [0.97 – 1.21] 0.178

Family history 1

yes 0.88 [0.47 – 1.67] 0.704 1.08 [0.89 – 1.32] 0.425 1.28 [1.02 – 1.61] 0.035*

no 1.00 1.00 1.00

Family history 2

yes 1.46 [1.03 – 2.07] 0.035* 1.03 [0.90 – 1.18] 0.651 1.11 [0.95 – 1.23] 0.205

no 1.00 1.00 1.00

Acetylsalicylic acid use

yes 0.88 [0.65 – 1.20] 0.423 0.76 [0.68 – 0.85] < 0.0001* 1.25 [1.11 – 1.40] < 0.0001*

no 1.00 1.00 1.00

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Acetylsalicylic acid – regular intake of the drug

Table 10. Prevalence ratio for cancer and precancerous lesions ‒ third round of screening

Prevalence ratio for cancer and 95%

CI

p value Prevalence ratio for advanced adenoma and 95% CI

p value Prevalence ratio for adenoma and 95% CI

p value

Sex

men 1.00 1.00 1.00

women 0.79 [0.64– 0.97] 0.024* 0.66 [0.61 – 0.70] < 0.0001* 0.76 [0.71 – 0.81] < 0.0001*

Age groups ( years )

50- 54 1.00 1.00 1.00

55 - 59 1.40 [0.81 – 1.61] 0.464 1.03 [0.94 – 1.13] 0.528 1.14 [1.03 – 1.25] 0.012*

60 - 64 1.74 [1.31 – 2.31] < 0.0001* 1.14 [1.05 – 1.24] 0.001* 1.17 [1.07 – 1.28] < 0.0001*

65 + 2.17 [1.59 – 2.96] < 0.0001* 1.11 [1.00 – 1.22] 0.043* 1.24 [1.12 – 1.37] < 0.0001*

Family history 1

yes 1.32 [0.73 – 2.43] 0.358 1.16 [0.95 – 1.42] 0.151 0.94 [0.75 – 1.18] 0.596

no 1.00 1.00 1.00

Family history 2

yes 0.99 [0.63 – 1.54] 0.948 1.16 [1.02 – 1.32] 0.029* 0.95 [0.81 – 1.10] 0.454

no 1.00 1.00 1.00

Acetylsalicylic acid

yes 0.94 [0.68 – 1.29] 0.695 0.83 [0.75 – 0.93] 0.001* 1.04 [0.94 – 1.16] 0.441

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* significant difference Legend:

Family history 1 ‒ first grade relative with colorectal cancer < 60 years of age

Family history 2 ‒ first grade relative with colorectal cancer > 60 years of age or >=2 second grade relatives with colorectal cancer

Acetylsalicylic acid – regular intake of the drug

no 1.00 1.00 1.00

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