Slovenian colorectal cancer screenig programme SVIT–results of pilot phase

Abstract

Background: Colorectal cancer (CRC) is the third most common cancer in the USA. In Slovenia, CRC is the second most common cancer after skin cancers. Five-year survival depends on the clinical stage at presentation. Patients withearlier clinical stages can be found only by means of a national screening programme. Results: In the pilot phase of the Slovenian National Screening Programme SVIT we invited 9091 patients aged 64 to 68 years from Ljubljana, Kranj and Celje region; 3807 persons responded to our invitation (41.9 %). Two samples for fecal immune tests were sent to 3117 study subjects who met inclusion criteria, and we received 2829 tests back. Among them 7.5 % of tests were possitive. Untill 11 February 2009, there were 193 colonoscopies performed in DC Bled, DC Lipa and AM DC Rogaška. Histology specimens were taken from 135 patients (70 %). Adenoma detection rate was 53.8 %, with the number of adenomas per patient ranging from 1 to 17 (2.4 on average). Advanced adenomas were detected in 60 (31 %) of patients. Invasive carcinomas were detected in 15 patients (7.6 %), 10 of them (73.3 %) were in clinical stages I and II. Conclusions: We have proved that CRC screening programme can detect patients with CRC in early clinical stages. Adenomas and invasive cancers were detected in 61.7 % of patients. In almost all patients adenomas were removed at screening colonoscopy, thus reducing the possibility of later development of CRC in those patients. We have proved that CRC screening programme SVIT in Slovenia can be very effective. When SVIT will be launched in our country in full scale and compliance rate will exceed 60 %, we can expect to reduce CRC by 300 and CRC dependent deaths by 200 cases yearly.