Can colorectal cancer mass-screening organization be evidence-based? Lessons from failures: The experimental and pilot phases of the Lazio program
2008

Colorectal Cancer Screening in Lazio: Lessons from Failures

Sample size: 300000 publication Evidence: low

Author Information

Author(s): Federici Antonio, Barca Alessandra, Baiocchi Diego, Quadrino Francesco, Valle Sabrina, Borgia Piero, Guasticchi Gabriella, Giorgi Rossi Paolo

Primary Institution: Agency for Public Health, Lazio Region

Hypothesis

Can colorectal cancer mass-screening organization be evidence-based?

Conclusion

The feasibility study highlighted several limits of the model, primarily due to organizational choices not supported by evidence.

Supporting Evidence

  • 24% of GPs correctly recommended screening for CRC.
  • Colonoscopy was perceived as the most effective screening test by 80% of endoscopy center physicians.
  • Compliance with GPs was 54% compared to 17% with hospitals.
  • The immunochemical test had a compliance of 35.8% compared to 30.4% for Guaiac.
  • 30% of non-compliant individuals reported lack of time as the major reason for non-compliance.

Takeaway

This study looked at how to organize colorectal cancer screening better. It found that many problems came from how the program was set up, not from the tests themselves.

Methodology

A multidisciplinary Working Group reviewed literature and guidelines, conducted surveys, and initiated a feasibility study on a target population.

Potential Biases

Potential bias due to low GP engagement and variability in compliance rates.

Limitations

Low GP participation and administrative problems hindered the screening program's effectiveness.

Participant Demographics

Target population included individuals aged 50-74 in the Lazio region, totaling 1.5 million.

Digital Object Identifier (DOI)

10.1186/1471-2458-8-318

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