Effectiveness of population-based colorectal cancer screening programme in down-staging |
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| Institution: | 1. Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China;2. Hong Kong Cancer Registry, Hospital Authority, Hong Kong, China;3. Department of Health, Hong Kong, China;1. Quantify Research, Hantverkargatan 8, 112 21 Stockholm, Sweden;2. Amgen Inc., Center for Observational Research, South San Francisco, CA, United States;3. Institute of Environmental Medicine, Karolinska Institute, 171 77 Stockholm, Sweden;4. Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden;5. Amgen Inc., Center for Observational Research, One Amgen Center Drive 24-2-A, Thousand Oaks, CA 91320, United States;6. IMS Health/Pygargus, Sveavägen 155, 113 46 Stockholm, Sweden;7. LIME/Medical Management Centre, Karolinska Institute, 171 77 Stockholm, Sweden;8. Uppsala University, 751 05 Uppsala, Sweden;1. Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan;2. Section of Pulmonary and Critical Care, Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan;3. Pharmacy Student, University of Jordan, Amman 11972, Jordan;4. Volunteer Research Program at King Hussein Cancer Center, Amman 11941, Jordan;5. Medical Student, University of Jordan, Amman 11972, Jordan;1. Oslo University Hospital, Oslo, Norway;2. Division of Surgery and Interventional Science, University College London and Department of Urology, University College Hospitals National Health Service Foundation Trust, London, United Kingdom;3. Department of Urology, North Hampshire and Basingstoke Hospital, Hampshire Hospitals National Health Service Foundation Trust, Basingstoke, United Kingdom;1. Servicio de Urología, Complejo Asistencial Universitario de León, León, España;2. Grupo de Investigación en Interacción Gen-Ambiente-Salud, Universidad de León, León, España;3. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España;4. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España;5. Servicio de Anatomía Patológica, Complejo Asistencial Universitario de León, León, España;1. Department of Cancer Strategy, Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka City, Osaka Prefecture 541-8567, Japan;2. Inequalities in Cancer Outcome Network, Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom |
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| Abstract: | BackgroundThis is the first evaluation study to assess the demographic characteristics of the colorectal cancer (CRC) cases detected in the prevalent round of the population-based Colorectal Cancer Screening Programme (CRCSP) in Hong Kong and to explore the effectiveness of the programme on the stage distribution of CRC.MethodsThis study covered the period between 28 September 2016 and 31 December 2018. Information on CRC diagnosis, age and stage at diagnosis were retrieved and reviewed by the Hong Kong Cancer Registry (HKCaR). The CRC detection rate among CRCSP-screened participants and incidence rate among the Hong Kong general population were calculated respectively. The odds ratio (OR) was calculated to measure the strength of association and quantify the effect of CRCSP on stage shift between CRCSP-detected CRC cases and an age-matched cohort of CRC cases diagnosed outside the programme.ResultsThe CRC detection rate among participants of the CRCSP during the study period was 736.0/100,000, whereas the overall CRC incidence rate among general population of similar age groups was 393.7/100,000. For all ages and both sexes, the OR of stage I CRCSP-detected CRC compared to the CRC from the age-matched cohort was 3.91 (95%CI=3.41–4.48) and the OR dropped to 0.54 (95%CI=0.41–0.70) at stage IV. Meanwhile, the overall OR of CRCSP-detected CRC compared to CRC from the age-matched cohort dropped from 2.24 (95%CI=1.97–2.56) to 1.62 (95%CI=1.40–1.87) with increasing age.ConclusionThe present study has demonstrated the initial impact of the CRCSP on shifting the stage at diagnosis towards earlier stage. The benefit of stage-shift was similar for all ages from 60 to 77 in both sexes and seems to increase with younger age. Given the stage-dependent survival outcomes, this stage-shift could lead to a reduction in CRC-associated mortality in Hong Kong in future. |
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| Keywords: | Colorectal cancer Population-based screening programme Staging Sex/gender difference |
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