Result card

  • CUR14: What kind of variations in use of CRC screening methods are there across countries/regions/settings?
English

What kind of variations in use of CRC screening methods are there across countries/regions/settings?

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

Internal reviewers: Laura Cacciani, Sophie Brunner, Esther Kraft

Population-based screening requires the identification and personal invitation of each person in the eligible target population (by an office or special agency). There are a number of established CRC screening programmes worldwide. Other countries are implementing pilots or considering the introduction of screening programmes {52, 57}. Several variations exist among the various programmes. Dimensions in which the programmes may differ include for example: population targeted (age groups targeted most often include persons aged ≥50 years), screening interval, monitoring mechanisms, methods of contacting eligible population, location of testing etc. The primary method used for screening also varies between countries. The following Table provides an overview of the screening strategies employed in European countries. It is based on data from First Report on the implementation of the European Council Recommendation on cancer screening {58}. Data were updated in the cases where more recent information was found.

Table 1: Overview of CRC screening practices in European countries

Country

CRC screening programme

Target population (eligible age in years)

Screening strategy

Screening interval

(years or times in LT)

Source

Austria

Natw, opp

 

50+

 

colonoscopy

10

EUnetHTA Survey 2013

FOBT (gFOBT)

1 or 2

EUnetHTA Survey 2013

Pop-b (province of Burgenland)

50+

FOBT (FIT)

1

EUnetHTA Survey 2013

Belgium

Natw, pop-b

n.a.

FOBT/CS

n.a.

(59) (status in 2011)

Bulgaria

Natw, opp

31+

FOBT

1

(58) (status in 2007)

Cyprus

Natw, pop-b

n.a.

colonoscopy

n.a.

(59) (status in 2011)

n.a.

FOBT (gFOBT)

n.a.

Croatia

Natw, pop-b

50-74

FOBT (gFOBT)

2

EUnetHTA Survey 2013

Czech Republic

Natw, opp

50-54

FOBT

1

(57) (status in 2009)

55+

FOBT (gFOBT)

2

55+

colonoscopy

10

Denmark

Natw, pop-b

n.a.

FOBT/CS

n.a.

(59) (status in 2011)

Estonia

Pop-b, planned

n.a.

FOBT

n.a.

(60)

Finland

Natw, pop-b

60-69

FOBT

2

(58) (status in 2007)

France

 Natw, pop-b

 

50-74 with no symptoms of CRC and moderate risk of CRC.

FOBT (gFOBT*)

2

EUnetHTA Survey 2013

Germany

opp

50-55

FOBT (gFOBT)

1

(57) (status in 2009)

55+

FOBT (gFOBT)

2

50+

colonoscopy

10

Greece

opp

50-70

FOBT

2

Ministerial Decision (Government Gazette Β 3054/2012)

50+

Colonoscopy

10

Hungary

Pop-b, natw pilot

50-70

FOBT

2

(58) (status in 2007)

Ireland

Pop-b

n.a.

FOBT

n.a.

(59) (status in 2011)

Italy

Regional variations

50-69 (70-75)

 

FOBT

 

οnly 1 out of 21 programmes proposes flexible sigmoidoscopy (FS) once in a lifetime to subjects 60+ and FIT for non-responders to FS

2

(58) (status in 2007)

Italy (Lazio Region)

Pop-b

50-74

FOBT (FIT)

2

EUnetHTA Survey 2013

Italy (Veneto Region)

Pop-b

50-69

FOBT (FIT)

2

EUnetHTA Survey 2013

Latvia

Natw, opp

50+

FOBT

1

(58) (status in 2007)

Lithuania

Natw, pop-b

50-75

 

FOBT (FIT)

2

EUnetHTA Survey 2013

Luxembourg

Opp

 natw pop-b planned

50+

FOBT

2

EUnetHTA Survey 2013

50+

colonoscopy

10

Malta

Pop-b

n.a.

FOBT

n.a.

(59) (status in 2011)

Netherlands

No prog

 

 

 

(58) (status in 2007)

Poland

Natw, pop-b

50-65

colonoscopy

10

(58) (status in 2007)

Portugal

Pop-b, natw planned

50-70

FOBT

2

(58) (status in 2007)

Romania

Pop-b, natw planned

50-47

 

FOBT

2

EUnetHTA Survey 2013

Russia

Pop-b

Certain age groups 45+ The programme is planned to cover the total population over 45 y. o. in 2016.

FOBT (FIT)

 

EUnetHTA Survey 2013

Scotland

Pop-b

50-74

FOBT (gFOBT)

FIT as a reflex test

2

EUnetHTA Survey 2013

Slovak Republic

Opp, natw

50+

FOBT

 

(58) (status in 2007)

Opp, natw planned

50+

colonoscopy

10

Slovenia

Natw, pop-b

50-69

FOBT (FIT)

2

EUnetHTA Survey 2013

Spain

Pop-b: Catalonia, Valencia, Murcia, Canary Islands, La Rioja and Basque Country

opp: rest of Spain

50-69

 

FOBT (FIT)

2

EUnetHTA Survey 2013

Sweden

Pop-b, regional planned

60-69

FOBT

2

(58) (status in 2007)

England

Pop-b, natw

50-75

FOBT

2

(57) (status in 2009)

* France: Although gFOBT is still considered as the reference test, a switch to FIT is recommended and encouraged by national authorities. The Cancer plan 2009-2013, sets the goal odf "Gradually roll out use of the immunological test for colorectal cancer screening to the whole of the country". 7 regions tried using FIT for the national screening programme: Alsace, Aquitaine, Lorraine, Midi-Pyrénées, Pays de la Loire, Picardie, Rhône-Alpes.

Abbreviations: pop-b (population-based), opp (opportunistic), no prog (no programme), natw (nationwide), pilot (piloting), plan (planning)

 

In CUR 14-Appendix 1, epidemiological data on CRC are presented for groups of countries according to CRC screening practices.

pdf10936.CUR-14 Appendix 1

The text in this Assessment Element describes CRC screening programmes targeting individuals at average risk for CRC (which is the scope of the current report). Screening programmes for high-risk individuals are not discussed.

Important
Partially
Huic M et al. Result Card CUR14 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