Colorectal cancer screening is highly effective in reducing deaths from this disease.

At the European Cancer Congress 2013 meeting in Amsterdam, Professor Philippe Autier, Vice President, Population Studies, at the International Prevention Research Institute, Lyon, France reported on results extracted from data on colorectal cancer (CRC) collected as part of the Survey of Health, Ageing, and Retirement in Europe (SHARE) project on exposure to screening in men and women aged 50 and over in 11 European countries between 1989 and 2010.

Colorectal cancer screening is carried out using either faecal occult blood testing (FOBT) followed by colonoscopy in people with a positive test or in some parts of Europe colonoscopy directly without a preliminary FOBT. Colonoscopy involves examining the interior of the colon using a tiny video camera on a flexible tube passed upwards from the rectum. Professor Autier said that, “We saw quite clearly that the greater proportions of men and women who were screened, the greater the reductions in mortality.”

For example, 34% of men in France aged 50 or more and 12% of men in the same age group in The Netherlands had an endoscopic screening during the period studied. CRC mortality decreased by 31% in men in France but by only 4% in the Netherlands over the same period. A similar pattern was seen in women from the two countries. A comparison between Austria and Greece showed that CRC rates fell by 39% for men and 47% for women in Austria where 35% of men had undergone an endoscopy. However CRC rates rose by 30% in men and 2% in women in Greece where only 8% of men had undergone colonoscopy during the study period. The endoscopy figures for women were not reported in the European Cancer Congress press release.

Professor Autier also noted that since the main goal of CRC screening is to remove polyps in the bowel, the risk of over-diagnosis is low, unlike that seen in breast and prostate cancer screening. He went on to suggest that since screening for colorectal cancer (CRC) in European countries is highly effective in reducing mortality from the disease, some of the resources currently being devoted to breast and prostate screening programmes, where the evidence of effectiveness is much less clear-cut, should be reallocated to the early detection of CRC.

Sources

ECC 2013 Press Release

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