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C R C s c r e e n i n g i n t h e N e t h e r l a n d s ; f r om p i l o t s t o n a t i o n a l p r o g r amm e M a r i e - L o u i s e H e i j n e n , P h D I r i s

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SLIDE 1

C R C s c r e e n i n g i n t h e N e t h e r l a n d s ; f r

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p i l

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s t

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a t i

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a l p r

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r amm e

M a r i e

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i s e H e i j n e n , P h D I r i s L a n s d

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p

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e l a a r , P h D

1 7 O c t

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e r 2 1 4 M e e t i n g W E O C R C S c r e e n i n g C

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i t t e e

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SLIDE 2

L e a d

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p t

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h e b

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e l c a n c e r s c r e e n i n g p r

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r amm e

2 6 : S t a r t

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p i l

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s c r e e n i n g p r

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r amm e s 2 9 : A d v i s

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y r e p

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t i s s u e d b y t h e H e a l t h C

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n c i l

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t h e N e t h e r l a n d s 2 1 1 : F e a s i b i l i t y s t u d y c

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d u c t e d b y R I V M J u n e 2 1 1 : M i n i s t e r i a l d e c i s i

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E a r l y 2 1 3 : A p p l i c a t i

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a n d r e c

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e n d a t i

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f

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p e rm i t u n d e r P

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S c r e e n i n g A c t S e p t em b e r 2 1 3 : S t a r t

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p i l

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J a n u a r y 2 1 4 : N a t i

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a l l a u n c h

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SLIDE 3

C R C s c r e e n i n g s t a r t e d e n d

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J a n u a r y 2 1 4

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e r : 4 7 3 , 4 3 5 i n v i t e e s ; 1 4 , 8 9 4 c

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c

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i e s

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SLIDE 4

I n J u l y c u t

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c

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d e c i s i

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e x p l a i n e d t h i s m

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n i n g i n F I T f

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s c r e e n i n g s e s s i

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t t p : / / w w w . r i vm . n l / e n / T

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r amm e –N e x t y e a r c

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p a r a t i v e s t u d y F O B G

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d a n d O C s e n s

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N

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: r e s u l t s

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f i r s t h a l f y e a r w i t h c u t

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f 8 8 n g /m l b y E r a sm u s M e d i c a l C e n t r e + A n t

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k h

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p i t a l , n a t i

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SLIDE 5

Invitation and participation

National Monitoring & Evaluation Colorectal Cancer Screening Programme Erasmus MC – NKI / AvL

Target population: 891,294 Invited: 189,610 Not yet invited: 701,684 Participants: 129,395 (68.2%) Non-participants: 22,255 (11.7%) Non-responders: 37,960 (20.0%) Reminder: 57,023 (95.9% of non-responders)

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SLIDE 6

0% 20% 40% 60% 80% 100% 1938 1939 1947 1949 1951 Totaal Invited Not yet invited

Invitations per birth cohort

terug National Monitoring & Evaluation Colorectal Cancer Screening Programme Erasmus MC – NKI / AvL

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SLIDE 7

Participation: 68.2%

National Monitoring & Evaluation Colorectal Cancer Screening Programme Erasmus MC – NKI / AvL

0% 10% 20% 30% 40% 50% 60% 70% 80% Men Women 1938 1939 1947 1949 1951 Total

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SLIDE 8

Not analyzable: 1,150 (0.9%) Unreliable: 946 (0.7%) Participants with analyzable FIT: 127,680 (98.7%) Positive test: 15,383 (12.0%) Negative test: 112,297 (88.0%) Participants: 129,395 (68.2%)

Screening

National Monitoring & Evaluation Colorectal Cancer Screening Programme Erasmus MC – NKI / AvL

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SLIDE 9

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% Men Women 1938 1939 1947 1949 1951 Total

Postivity rate: 12.0%

National Monitoring & Evaluation Colorectal Cancer Screening Programme Erasmus MC – NKI / AvL

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SLIDE 10

Intake colonoscopy

National Monitoring & Evaluation Colorectal Cancer Screening Programme Erasmus MC – NKI / AvL

Positive test: 15,383 (12.0%) Intake: 13,220 (85.9%) Non-participants: 1,625 (10.6%) No-show: 225 (1.5%) Reminder: 224 (99.6% of no- shows) Colonoscopy: 12,167 (92.0%)

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SLIDE 11

9 2 % 1 % % 2 % 5 %

C

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c

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y C T c

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r a p h y D i f f e r e n t i n t a k e l

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a t i

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C

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c

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y d e l a y e d E x c l u s i

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C

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c l u s i

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s i n t a k e

N a t i

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a l M

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i t

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i n g & E v a l u a t i

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C

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e c t a l C a n c e r S c r e e n i n g P r

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r a m m e E r a s m u s M C – N K I / A v L

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SLIDE 12

Colonoscopy

National Monitoring & Evaluation Colorectal Cancer Screening Programme Erasmus MC – NKI / AvL

Non-advanced adenomas: 2,640 (23.1%) Colorectal cancer: 763 (6.7%) Advanced adenomas: 3,832 (33.5%) Non-adenomatous findings: 4,195 (36.7%) Colonoscopy: 11,430 (95.4%)

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SLIDE 13
  • Of the 15.383 particpants with a positive test result currently 11,430

(74.3%) received a colonoscopy

Colonoscopies per postive test result

terug National Monitoring & Evaluation Colorectal Cancer Screening Programme Erasmus MC – NKI / AvL

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SLIDE 14

7 % 3 3 % 2 3 % 5 % 3 2 %

C

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e c t a l c a n c e r A d v a d e n

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a s N

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d v a d e n

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a s S e r r a t e d p

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y p s N

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i n d i n g s

* O p b r e n g s t v a n c

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c

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t

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e r e e n m e t d e P P V v a n i F O B T

Y i e l d

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c

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y

N a t i

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a l M

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i t

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i n g & E v a l u a t i

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C

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e c t a l C a n c e r S c r e e n i n g P r

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r a m m e E r a s m u s M C – N K I / A v L

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SLIDE 15

Pilot studies National program 88 ng/ml National program 275 ng/ml Test positivity 6.4% 12.0% 7.2% Colonoscopy 85.7% 74.3% Detection rate* CRC 4.5 per 1,000 5.9 per 1,000 5.0 per 1,000 Detection rate* CRC+AA 28.3 per 1,000 36.2 per 1,000 25.4 per 1,000 PPV CRC 8.2% 6.7% 9.5% PPV CRC+AA 51.6% 40.2% 48.1% False-positive FIT† 48.4% 59.8% 51.9% NNScope CRC 12.2 14.9 10.5 NNScope CRC+AA 1.8 2.5 2.1

Positivity and detection rates

National Monitoring & Evaluation Colorectal Cancer Screening Programme Erasmus MC – NKI / AvL

PPV = Positive predictive value of a positive FIT

* Detection rate per 1,000 screened individuals † False-positive FIT = percentage of positive FIT for which no advanced neoplasia are found during

follow-up colonoscopy

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SLIDE 16

F u r t h e r i n f

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a t i

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h t t p : / / w w w . r i vm . n l / e n / T

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i c s / B / B

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e l _ c a n c e r _ s c r e e n i n g _ p r

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r amm e

m a r i e- l

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i s e . h e i j n e n@ r i vm . n l i . v

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e l a a r@ e r a sm u sm c . n l