Adherence to follow-up and resource use after abnormal FIT-screening: Evaluation of the Danish colorectal cancer screening program.

Autor:	Jørgensen SF; University Research Clinic for Cancer screening, Randers Regional Hospital, Randers, Denmark.; Department of Data, Innovation and Research, Lillebaelt Hospital, Vejle, Denmark., Larsen PT; University Research Clinic for Cancer screening, Randers Regional Hospital, Randers, Denmark.; Department of Clinical Medicine, Aarhus University Faculty of Health Sciences, Aarhus, Denmark., Erichsen R; Department of Clinical Epidemiology, Aarhus University Hospital, Randers, Denmark.; Department of Surgery, Randers Regional Hospital, Randers, Denmark., Andersen B; University Research Clinic for Cancer screening, Randers Regional Hospital, Randers, Denmark.; Department of Clinical Medicine, Aarhus University Faculty of Health Sciences, Aarhus, Denmark., Rebolj M; Centre for Cancer Screening, Prevention, and Early Detection, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom of Great Britain and Northern Ireland., Njor S; Department of Clinical Medicine, Aarhus University Faculty of Health Sciences, Aarhus, Denmark.; University Research Clinic for Cancer screening, Randers Regional Hospital, Randers, Denmark.; Department of Data, Innovation and Research, Lillebaelt Hospital, Vejle, Denmark.
Jazyk:	angličtina
Zdroj:	Endoscopy international open [Endosc Int Open] 2024 May 03; Vol. 12 (5), pp. E649-E658. Date of Electronic Publication: 2024 May 03 (Print Publication: 2024).
DOI:	10.1055/a-2297-9622
Abstrakt:	Background and study aims The effectiveness of colorectal cancer screening programs depends on adherence to surveillance protocols for screening-positive individuals. We evaluated adherence in the Danish population-based screening program and estimated the volume of diagnostic resources required to achieve this adherence. Patients and methods In this register- and population-based study, we included individuals with a positive fecal immunochemical test (FIT) screening from 2014 to 2017 and followed them until mid-2022. All endoscopic, imaging, and surgical procedures performed at public and private hospitals were identified. Adherence to national protocols was reported in terms of proportions and timeliness. Use of diagnostic and surveillance procedures was estimated during a 4-year post-screening period. Results Among 82,221 individuals with a positive FIT test, 84% had a baseline colonoscopy within 1 month. After removal of intermediate or high-risk adenomas, 12% and 6%, respectively, did not have any follow-up. Only ~50% had timely surveillance. Approximately 10% to 20%, depending on their referral diagnosis, did not have a second surveillance colonoscopy. In addition, 12% with a negative colonoscopy had a second colonoscopy within 4 years. Conclusions High adherence to baseline colonoscopy after positive FIT-screening is followed by lower adherence throughout the adenoma surveillance program. Better adherence to the guidelines could potentially improve the effectiveness and efficiency of the screening program. Competing Interests: Conflict of Interest Matejka Rebolj declares the following conflict of interest: The former Public Health England (now: NHS England and Department of Health/Office for Health Improvement and Disparities) provided financing for the epidemiological evaluation of various cervical screening studies; current and former member of various expert groups providing advice to the English Cervical Screening Programme; attended meetings with HPV test manufacturers; fees for attendance at advisory board and other meetings organised by Hologic, shared with employer, including travel cost reimbursement if applicable. The remaining authors have no conflict of interest to declare. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu