Colorectal cancer screening: The surgery rates they are a-changing. A nationwide study on surgical resections in Italy.
Aged
Colectomy
/ methods
Colorectal Neoplasms
/ diagnosis
Databases, Factual
/ statistics & numerical data
Early Detection of Cancer
/ methods
Feces
Female
Hospitalization
/ statistics & numerical data
Humans
Immunochemistry
Incidence
Italy
/ epidemiology
Male
Middle Aged
Neoplasm Staging
Outcome Assessment, Health Care
Colorectal cancer
Epidemiology
Screening
Surgery
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
09
07
2018
revised:
21
09
2018
accepted:
17
10
2018
pubmed:
20
11
2018
medline:
14
6
2019
entrez:
20
11
2018
Statut:
ppublish
Résumé
Growing evidence suggests that colorectal cancer (CRC) screening based on the fecal immunochemical test (FIT) reduces CRC incidence and surgical resection rates. To compare trends in surgery for proximal and distal CRC among Italian regions at different stages of screening implementation. From the National Hospital Discharge Database we selected hospitalizations with CRC resection of residents aged 50-74 years during 2002-2014, and computed surgery rates for the 8 most populous Italian regions with/without a screening program. In regions with screening, implemented around 2006-2007, the annual percent change (APC) of distal CRC resection was +1.7 (95% confidence interval -1.0, 4.4) during 2002-2007 and -9.1 (-10.6, -7.7) during 2007-2014. No significant change was observed in regions without screening. The APC for proximal colon resection in regions with screening was +5.8 (2.5, 9.0) during 2002-2007 and -4.1 (-5.8, -2.4) during 2007-2014, while in regions without screening surgical rates increased through the whole study period. Compared to 2002, in 2014 distal CRC resection rates were greatly reduced in regions with screening, reaching values similar to proximal CRC resection. Following the implementation of screening programs surgery rates steeply decreased, confirming the deep impact of FIT-based screening on the burden of CRC.
Sections du résumé
BACKGROUND
Growing evidence suggests that colorectal cancer (CRC) screening based on the fecal immunochemical test (FIT) reduces CRC incidence and surgical resection rates.
AIMS
To compare trends in surgery for proximal and distal CRC among Italian regions at different stages of screening implementation.
METHODS
From the National Hospital Discharge Database we selected hospitalizations with CRC resection of residents aged 50-74 years during 2002-2014, and computed surgery rates for the 8 most populous Italian regions with/without a screening program.
RESULTS
In regions with screening, implemented around 2006-2007, the annual percent change (APC) of distal CRC resection was +1.7 (95% confidence interval -1.0, 4.4) during 2002-2007 and -9.1 (-10.6, -7.7) during 2007-2014. No significant change was observed in regions without screening. The APC for proximal colon resection in regions with screening was +5.8 (2.5, 9.0) during 2002-2007 and -4.1 (-5.8, -2.4) during 2007-2014, while in regions without screening surgical rates increased through the whole study period. Compared to 2002, in 2014 distal CRC resection rates were greatly reduced in regions with screening, reaching values similar to proximal CRC resection.
CONCLUSION
Following the implementation of screening programs surgery rates steeply decreased, confirming the deep impact of FIT-based screening on the burden of CRC.
Identifiants
pubmed: 30449608
pii: S1590-8658(18)31205-2
doi: 10.1016/j.dld.2018.10.011
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
304-309Informations de copyright
Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.