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Policies of screening for colorectal cancer in European countries

  • Iñaki Gutiérrez-Ibarluzea (a1), José Asua (a2) and Kepa Latorre (a3)

Objectives: The aim of this study was to analyze the current status of population screening for colon/rectum cancer in Europe to compare the different strategies, the coverage, the existence of pilot experiences, regional coverages, and the risk factors considered in each strategy.

Methods: A comprehensive, systematic search was performed in the literature for documents addressing population screening for colon/rectum cancer in Europe. An ad hoc questionnaire was prepared including questions considered relevant. The questionnaire was reviewed by experts in the area. To identify key informants, colleague members of the International Network of Agencies for Health Technology Assessment (INAHTA), participants in the EUnetHTA project, or representatives of the ministries of health of the different European countries were contacted. The information provided by key informants was checked with information directly obtained from the ministries of health, gray literature, and research documents.

Results: An 88 percent response rate was obtained. In countries for which no questionnaire data were collected, information was directly retrieved from the Web sites of the corresponding ministries. Four countries were found to perform population screenings: Austria, France, Germany, and the United Kingdom. However, they used different strategies. Five countries had begun regional or local strategies: Denmark, Finland, Italy, Spain, and Switzerland, and two additional countries (the Netherlands and Norway) reported ongoing research studies intended to determine the best strategy to implement a population-based screening program. Differences were found in age range, procedure chosen, and follow-up period.

Conclusions: Even though the European Council recommended a wider implementation of population screening for colon/rectum cancer, our results suggest that this recommendation continues to be valid. The differences found in screening strategies (in terms of age range, procedures, risk factors considered, and follow-up periods) are not warranted by the results obtained in research studies or regional-national cancer registries.

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1. F Berrino , R De Angelis , M Sant ; EUROCARE Working group. Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: Results of the EUROCARE-4 study. Lancet Oncol. 2007;8:773783.

3. A Castells , M Marzo , B Bellas Guia clinica de prevencion del cancer colorrectal. Hospital Clinic, Barcelona, Spain. Gastroenterol Hepatol. 2004;27:573634.

6. J Ferlay , P Autier , M Boniol Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol. 2007;18:581–92.

7. A Ferrandez , S Sainz . Detección precoz del cáncer de colon. Estrategias individuales y colectivas. Huntsman Cancer Institute. Salt Lake City. Utah. Rev Clin Esp. 2003;203:542544.

14. DK Rex . American College of Gastroenterology action plan for colorectal cancer prevention. Am J Gastroenterol. 2004;99:574577.

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19. JJ Viñes , E Ardanaz , A Arrazola , I Gaminde . Epidemiología poblacional del cáncer colorrectal: Revisión de la causalidad. An Sist Sanit Navar. 2003;26:7997.

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International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
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