Colorectal cancer screening
Colorectal cancer screening is the youngest organized programme and its full implementation was reached in 2005. The regional protocol is addressed to women and men 50-69 years old. They are invited to do an immunological faecal occult blood test (FIT) every two year. When FIT values result over 19 µg of haemoglobin/gr faeces a total colonscopy is offered. In case of incomplete colonoscopy or when contraindications are present a virtual colonscopy is recommended in order to complete the diagnostic assessment. In table 1 quality indicators of the last available years (2014-2016) are shown as well as acceptable and desirable standards from the Italian group for colorectal cancer screening (GISCoR).
Table 1 – Main indicators (first screening + repeat screening) of colorectal cancer screening programmes performance in Tuscany Region. Period 2014-2016.
|
Indicators |
Years |
||
|
2014 |
2015 |
2016 |
|
|
Adjusted extension (%) |
88.4 |
99.5 |
93.6 |
|
Adjusted participation (%) |
52.0 |
49.4 |
49.3 |
|
Positivity rate (%) |
4.6 |
4.9 |
4.7 |
|
Compliance with assessment (%) |
75.3 |
78.0 |
77.5 |
|
Total colonoscopies (%) |
86.4 |
91.5 |
91.6 |
|
Crude detection rate for cancer*(‰) |
1.1 |
1.1 |
1.1 |
|
Crude detection rate for advanced adenoma*(‰) |
6.4 |
6.9 |
6.2 |
|
PPV for cancer (%) |
3.1 |
2.8 |
2.7 |
|
PPV for advanced adenoma (%) |
17.3 |
17.1 |
15.1 |
|
Inadequate screening tests (%) |
0.5
|
0.5 |
0.6 |