TY - JOUR
T1 - Impact of delayed screening invitations on screen-detected and interval cancers in the Dutch colorectal cancer screening programme
T2 - individual-level data analysis
AU - Toes-Zoutendijk, Esther
AU - de Jonge, Lucie
AU - van Iersel, Carola Adriana
AU - Spaander, Manon C. W.
AU - van Vuuren, Anneke J.
AU - van Kemenade, Folkert
AU - Ramakers, Christian R.
AU - Dekker, Evelien
AU - Nagetaal, Iris D.
AU - van Leerdam, Monique E.
AU - Lansdorp-Vogelaar, Iris
N1 - Funding Information: This research was funded by the National Institute for Public Health and the Environment. Publisher Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Objective To assess the impact of delayed invitation on screen-detected and interval colorectal cancers (CRC) within a faecal immunochemical testing (FIT)-based CRC screening programme. Design All individuals that participated in 2017 and 2018 with a negative FIT and were eligible for CRC screening in 2019 and 2020 were included using individual-level data. Multivariable logistic regression analyses were used to assess the association between either the different time periods (ie, 'before', 'during' and 'after' the first COVID-19 wave) or the invitation interval on screen-detected and interval CRCs. Results Positive predictive value for advanced neoplasia (AN) was slightly lower during (OR=0.91) and after (OR=0.95) the first COVID-19 wave, but no significant difference was observed for the different invitation intervals. Out of all individuals that previously tested negative, 84 (0.004%) had an interval CRC beyond the 24 months since their last invitation. The time period of invitation as well as the extended invitation interval was not associated with detection rates for AN and interval CRC rate. Conclusion The impact of the first COVID-19 wave on screening yield was modest. A very small proportion of the FIT negatives had an interval CRC possibly due to an extended interval, which potentially could have been prevented if they had received the invitation earlier. Nonetheless, no increase in interval CRC rate was observed, indicating that an extended invitation interval up to 30 months had no negative impact on the performance of the CRC screening programme and a modest extension of the invitation interval seems an appropriate intervention.
AB - Objective To assess the impact of delayed invitation on screen-detected and interval colorectal cancers (CRC) within a faecal immunochemical testing (FIT)-based CRC screening programme. Design All individuals that participated in 2017 and 2018 with a negative FIT and were eligible for CRC screening in 2019 and 2020 were included using individual-level data. Multivariable logistic regression analyses were used to assess the association between either the different time periods (ie, 'before', 'during' and 'after' the first COVID-19 wave) or the invitation interval on screen-detected and interval CRCs. Results Positive predictive value for advanced neoplasia (AN) was slightly lower during (OR=0.91) and after (OR=0.95) the first COVID-19 wave, but no significant difference was observed for the different invitation intervals. Out of all individuals that previously tested negative, 84 (0.004%) had an interval CRC beyond the 24 months since their last invitation. The time period of invitation as well as the extended invitation interval was not associated with detection rates for AN and interval CRC rate. Conclusion The impact of the first COVID-19 wave on screening yield was modest. A very small proportion of the FIT negatives had an interval CRC possibly due to an extended interval, which potentially could have been prevented if they had received the invitation earlier. Nonetheless, no increase in interval CRC rate was observed, indicating that an extended invitation interval up to 30 months had no negative impact on the performance of the CRC screening programme and a modest extension of the invitation interval seems an appropriate intervention.
KW - COLORECTAL CANCER SCREENING
KW - COVID-19
UR - http://www.scopus.com/inward/record.url?scp=85160253031&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/gutjnl-2022-328559
DO - https://doi.org/10.1136/gutjnl-2022-328559
M3 - Article
C2 - 37076272
SN - 0017-5749
VL - 72
SP - 1319
EP - 1325
JO - Gut
JF - Gut
IS - 7
ER -