TY - JOUR
T1 - The performance of colorectal cancer screening in Brazil
T2 - The first two years of the implementation program in barretos cancer hospital
AU - Guimarães, Denise Peixoto
AU - Mantuan, Larissa Andreoli
AU - De Oliveira, Marco Antonio
AU - Junior, Raphael Luiz
AU - Da Costa, Allini Mafra
AU - Rossi, Silvana
AU - Fava, Gilberto
AU - Taveira, Leonardo Nogueira
AU - Giardina, Kelly Menezio
AU - Talarico, Thais
AU - Costa, Maraisa
AU - Scapulatempo-Neto, Cristovam
AU - Matsushita, Marcus Medeiros
AU - Véo, Carlos Augusto
AU - Fregnani, José Humberto T. G.
AU - Reis, Rui M. V.
AU - Hawk, Ernest T.
AU - Mauad, Edmundo C.
N1 - Funding Information:
E.T. Hawk reports other from Boone Pickens Distinguished Chair for Early Prevention of Cancer (endowed chair award) and grants from NIH 5P30CA016672 during the conduct of the study. No disclosures were reported by the other authors.
Funding Information:
This study was funded by MCTI/FINEP/CT-INFRA (Centro de Estudos em Prevenc¸ão e Diagnóstico Precoce do Câncer), by the Public Ministry of Labor Campinas (Research, Prevention, and Education of Occupational Cancer), and by Barretos Cancer Hospital internal funds. A. Mafra da Costa is a recipient of a Post-Doc fellowship (FAPESP’s Thematic Research Project, 2018/22097-0 and 2019/21722/0), and R.M. Reis is a recipient of CNPq Productivity Fellowship.
Publisher Copyright:
© 2020 American Association for Cancer Research.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - Colorectal cancer is the second most common cancer in Brazil. Yet, a nationally organized colorectal screening program is not implemented. Barretos Cancer Hospital (BCH) is one of the largest Brazilian institution that cares for underserved patients. BCH developed a fecal immunochemical test (FIT)-based organized colorectal cancer screening program to improve colorectal cancer outcomes. This study aims to present the quality/performance measures of the first 2 years of the FIT-based colorectal cancer screening program and its impact on the colorectal cancer disease stage. Between 2015 and 2017, a total of 6,737 individuals attending the Outpatient Department of Prevention or the Mobile Unit of BCH, which visits 18 cities of Barretos county, ages 50 to 65 years, were personally invited by a health agent/nurse practitioner. Exclusion criteria were personal history of colorectal cancer, adenomatous polyps, inflammatory bowel disease, and colonoscopy, or flexible sigmoidoscopy performed in the past 5 years. European Union (EU) guidelines for colorectal cancer screening programs were evaluated. Overall, 92.8% returned the FIT, with an inadequate examination rate of 1.5%. Among the 6,253 adequately tested, 12.5% had a positive result. The colonoscopy compliance and completion rates were 84.6 and 98.2%, respectively. The PPVs were 60.0%, 16.5%, and 5.6% for adenoma, advanced adenoma, and cancer, respectively. Stage distribution of screen-detected cancers shows earlier stages than clinically diagnosed colorectal cancer cancers reported at BCH and Brazilian cancer registries. Our colorectal cancer screening program achieved desirable quality metrics, aligned with the EU guidelines. The observed shift toward earlier colorectal cancer stages suggests an exciting opportunity to improve colorectal cancer-related cancers in Brazil.
AB - Colorectal cancer is the second most common cancer in Brazil. Yet, a nationally organized colorectal screening program is not implemented. Barretos Cancer Hospital (BCH) is one of the largest Brazilian institution that cares for underserved patients. BCH developed a fecal immunochemical test (FIT)-based organized colorectal cancer screening program to improve colorectal cancer outcomes. This study aims to present the quality/performance measures of the first 2 years of the FIT-based colorectal cancer screening program and its impact on the colorectal cancer disease stage. Between 2015 and 2017, a total of 6,737 individuals attending the Outpatient Department of Prevention or the Mobile Unit of BCH, which visits 18 cities of Barretos county, ages 50 to 65 years, were personally invited by a health agent/nurse practitioner. Exclusion criteria were personal history of colorectal cancer, adenomatous polyps, inflammatory bowel disease, and colonoscopy, or flexible sigmoidoscopy performed in the past 5 years. European Union (EU) guidelines for colorectal cancer screening programs were evaluated. Overall, 92.8% returned the FIT, with an inadequate examination rate of 1.5%. Among the 6,253 adequately tested, 12.5% had a positive result. The colonoscopy compliance and completion rates were 84.6 and 98.2%, respectively. The PPVs were 60.0%, 16.5%, and 5.6% for adenoma, advanced adenoma, and cancer, respectively. Stage distribution of screen-detected cancers shows earlier stages than clinically diagnosed colorectal cancer cancers reported at BCH and Brazilian cancer registries. Our colorectal cancer screening program achieved desirable quality metrics, aligned with the EU guidelines. The observed shift toward earlier colorectal cancer stages suggests an exciting opportunity to improve colorectal cancer-related cancers in Brazil.
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U2 - 10.1158/1940-6207.CAPR-20-0179
DO - 10.1158/1940-6207.CAPR-20-0179
M3 - Article
C2 - 32998941
AN - SCOPUS:85100540846
SN - 1940-6207
VL - 14
SP - 241
EP - 251
JO - Cancer Prevention Research
JF - Cancer Prevention Research
IS - 2
ER -