CRC incidence decreases following start of national FIT-based screening program
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Colorectal cancer incidence and mortality decreased after implementation of a national fecal immunochemical test-based screening program in the Netherlands, according to research presented at Digestive Disease Week.
“Since 2014, a population-based CRC screening program was stepwise implemented in the Netherlands, using biennial FIT. As of 2019, the program was fully implemented, inviting all individuals aged between 55 [ to] 75 years using a FIT cutoff value of 47 g Hb/gram feces,” Emilie Breekveldt, PhD, Erasmus Medical Center department of public health, Netherlands Cancer Institute at Antoni van Leeuwnhoek Hospital, and colleagues wrote. “This study assessed the impact of the implementation of a national FIT-based CRC screening program on different outcomes of CRC.”
In a retrospective study, researchers collected CRC incidence data from the Netherlands Cancer Registry. Prior to the introduction of the Dutch national FIT-based screening program, CRC incidence was 215.5 per 100,000 persons in 2013; upon program introduction, this incidence rate first increased to 260.2 per 100,000 persons in 2015 and subsequently decreased to 180.4 per 100,000 persons in 2019. Similarly, incidence rates for advanced CRCs and CRC-related mortality also decreased from 2013 to 2018 (117.7 per 100,000 persons vs. 95.7 per 100,000 persons and 79.6 per 100,000 persons vs. 70.4 per 100,000 persons).
“We observed a decrease in overall CRC incidence rates as well as a decrease in advanced stage CRC incidence,” Breekveldt concluded. “Coupled with the improved treatment options, these are early indicators of a decrease in morbidity and mortality in the long-term as a result of the CRC screening program.”
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The Dutch national biennial FIT-based program was introduced in 2013. The authors reported that since the implementation, the incidence of CRC has declined steadily from 215 per 100,000 in 2013 to 180 per 100,000 in 2019, attributed to increased screening uptake. However, the authors did not report the national adherence to FIT screening and role of other factors such as aspirin use, smoking reduction or lifestyle changes.
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Breekveldt E, et al. Abstract 740. Presented at: Digestive Disease Week; May 21-23, 2021 (virtual meeting).
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