Landelijk bevolkingsonderzoek naar colorectaal carcinoom

Objective

To describe the effect of population screening for colorectal carcinoma (CRC) with the faecal immunochemical test, introduced in 2014, on the incidence of CRC in the Netherlands and to analyse differences between patient and tumour characteristics, stage distribution and treatment of carcinomas that were screening-detected and were not detected by screening (non-screening-detected).

Design

Retrospective observational study.

Method

We analysed data from the Netherlands Cancer Registry. We selected all CRCs diagnosed in the 2010-2016 period and calculated incidence rates standardised for the European population. For comparison between screening-detected and non-screening-detected carcinomas, we selected all CRCs diagnosed in 2015.

Results

The number of newly diagnosed CRCs rose from 13,028 in 2013 to 15,185 in 2014 and to 15,807 in 2015. This increase could only be seen for the birth years of people who had been invited for population screening during that particular year. The percentage of men was higher for screening-detected carcinomas than for non-screening-detected carcinomas (62% vs 55%). Screening-detected carcinomas were also more often in the left side of the colon (76% vs 64%). The percentage of patients with stage I CRC was higher in the group with screening-detected carcinomas (48% vs 16%). Patients with screening-detected carcinomas more often underwent local treatment or only resection without adjuvant or neoadjuvant treatment than the patients with non-screening-detected carcinomas.

Conclusion

During the first years after the introduction of population screening, the incidence of CRC has increased as the result of earlier detection. Screening-detected carcinomas have a more favourable stage distribution and these patients are undergoing less-invasive treatment more often.

Conflict of interest and financial support for this article: E. Toes-Zoutendijk and I. Lansdorp-Vogelaar have received grant support from the Netherlands Institute for Public Health and the Environment for monitoring and evaluation of the Dutch national colorectal cancer screening programme; G.A. Meijer serves as a member of the National Committee for Implementation of Colorectal Cancer Screening. Additional potential conflicts of interest have been reported. ICMJE forms provided by the authors are available online along with the full text of this article.