Result card

  • CUR12: Which countries use FIT for CRC screening?
  • CUR13: Which percentage of target population is accually screened in countries with CRC screening program with FIT? Jump to
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Which countries use FIT for CRC screening?

Authors: Mirjana Huic, Eleftheria Karampli, Silvia Florescu, Cipriana Mihaescu-Pintia

Internal reviewers: Laura Cacciani, Sophie Brunner, Esther Kraft

  • Data for Greece were added by one of the domain Investigators (EK).

A number of countries have organised CRC screening programmes (see CUR14), utilising different strategies. FOB testing is a widely implemented strategy, however there are differences in the type of tests used (gFOBT or iFOBT). From the information provided via the EUnetHTA members’ survey, use of immunochemical testing (FIT) was reported in 5 out of 11 (i. e. Austria, Russia, Luxembourg, Lithuania, Italy, Scotland, Spain, Romania, France, Croatia and Slovenia) European countries. In specific, FIT is used in the Regions of Veneto and Lazio in Italy, Lithuania, Russia, Slovenia and Spain. In Austria, FIT is used only in one province (Burgenland).

According to data (May 2008) from the International Cancer Screening Network {52}, CRC screening programmes utilising immunochemical techniques had been implemented in Hungary (2 pilots) and Italy. In Italy, the majority of programmes use FIT, a limited number offer flexible sigmoidoscopy (FS) once in a lifetime and FIT for non-responders to FS {53}.

Outside of Europe, FIT is the preferred method for CRC screening in Japan {54} and Australia {51}. In Canada, 3 out of 7 provinces (B. Columbia, Saskatchewan and Nova Scotia) implementing CRC screening programs with FOBTs as the entry method were utilising a FIT test {55}.

Important
Partially
Huic M et al. Result Card CUR12 In: Huic M et al. Health Problem and Current Use of the Technology In: Jefferson T, Cerbo M, Vicari N [eds.]. Fecal Immunochemical Test (FIT ) versus guaiac-based fecal occult blood test (FOBT) for colorectal cancer screening [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali; 2014. [cited 16 June 2021]. Available from: http://corehta.info/ViewCover.aspx?id=206

Which percentage of target population is accually screened in countries with CRC screening program with FIT?

Authors: Mirjana Huic, Eleftheria Karampli, Silvia Florescu, Cipriana Mihaescu-Pintia

Internal reviewers: Laura Cacciani, Sophie Brunner, Esther Kraft

Please see also ORG Domain.

Uptake or participation rate is defined in the European guidelines on CRC screening as "the number of people who have been screened, within a defined time frame following an invitation, as a proportion of all people who are invited to attend for screening" {43}. Participation rate is an early performance indicator as it is important for the overall effectiveness and cost-effectiveness of the CRC screening programme. European Guidelines {43} consider a minimum uptake of at least 45% as acceptable, however, it is recommended to aim for a participation rate of at least 65%.

Participation rates in FIT-based screening

 

Participation rates in various CRC screening programmes (pilot programmes, established programmes) in Europe and abroad are presented in the following Table 1.

 

Table 1: Participation rates in CRC screening with FIT

Country/Region

Participation rate

Source

 

 

 

Established population - based CRC screening programmes

 

 

 

Burgenland, Austria

35%

EUnetHTA Members Survey

Japan

17% (2002)

(54)

Tuscany, Italy

41% (1st round) (2001)

(44)

Lazio Region, Italy

30% (2011)

EUnetHTA Members Survey

Veneto Region, Italy

63.8% (2012)

EUnetHTA Members Survey

Lithuania

16.4%

EUnetHTA Members Survey

Russia

n.a. (programme established in 2013)

EUnetHTA Members Survey

Slovenia

1st screening round: 49.8%

EUnetHTA Members Survey

Spain

Catalonia 2000-2008: 14.4% adherence to screening recommendations, 18.4% were occasionally adherent

EUnetHTA Members Survey

Pilot CRC screening programmes

Australia

45.5% (2002-2004)

(56)

Netherlands

60% (1st round; 2006-2007)

(44)

 

Participation rates in gFOBT-based screening

In a review by the Irish Health Information and Quality Authority {44},  uptake (the proportion of individuals who complete a screening test in a particular screening round) of CRC screening using the gFOBT in the 1st round of pilot screening programmes ranged from 47% in the Netherlands to 55% in Scotland. Uptake increased to 53% and 55% in the 2nd and 3rd round respectively in the pilot from Scotland. Similar rates were reported in a 3-round pilot in France.

Data from the survey conducted in the framework of the present report provided additional information on participation rates in national population-based CRC screening programmes in France (for the period 2010-2011 participation rate was approximately 32%) and Croatia (19.9%).

 

Critical
Partially
Huic M et al. Result Card CUR13 In: Huic M et al. Health Problem and Current Use of the Technology In: Jefferson T, Cerbo M, Vicari N [eds.]. Fecal Immunochemical Test (FIT ) versus guaiac-based fecal occult blood test (FOBT) for colorectal cancer screening [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali; 2014. [cited 16 June 2021]. Available from: http://corehta.info/ViewCover.aspx?id=206

References