The Impact of a Six-Year Existing Screening Programme Using the Faecal Immunochemical Test in Flanders (Belgium) on Colorectal Cancer Incidence, Mortality and Survival: A Population-Based Study

Thuy Ngan Tran (), Sarah Hoeck, Harlinde De Schutter, Sharon Janssens, Marc Peeters and Guido Van Hal
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Thuy Ngan Tran: Centre for Cancer Detection, 8000 Bruges, Belgium
Sarah Hoeck: Centre for Cancer Detection, 8000 Bruges, Belgium
Harlinde De Schutter: Research Department, Belgian Cancer Registry, 1210 Brussels, Belgium
Sharon Janssens: Research Department, Belgian Cancer Registry, 1210 Brussels, Belgium
Marc Peeters: Department of Oncology, Antwerp University Hospital, 2650 Edegem, Belgium
Guido Van Hal: Centre for Cancer Detection, 8000 Bruges, Belgium

IJERPH, 2023, vol. 20, issue 2, 1-17

Abstract: The faecal immunochemical test (FIT) has been increasingly used for organised colorectal cancer (CRC) screening. We assessed the impact of a six-year existing FIT screening programme in Flanders (Belgium) on CRC incidence, mortality and survival. The Flemish CRC screening programme started in 2013, targeting individuals aged 50–74 years. Joinpoint regression was used to investigate trends of age-standardised CRC incidence and mortality among individuals aged 50–79 years (2004–2019). Their 5-year relative survival was calculated using the Ederer II method. We found that FIT screening significantly reduced CRC incidence, especially that of advanced-stage CRCs (69.8/100,000 in 2012 vs. 51.1/100,000 in 2019), with a greater impact in men. Mortality started to decline in men two years after organised screening implementation (annual reduction of 9.3% after 2015 vs. 2.2% before 2015). The 5-year relative survival was significantly higher in screen-detected (93.8%) and lower in FIT non-participant CRCs (61.9%) vs. FIT interval cancers and CRCs in never-invited cases (67.6% and 66.7%, respectively). Organised FIT screening in Flanders clearly reduced CRC incidence (especially advanced-stage) and mortality (in men, but not yet in women). Survival is significantly better in screen-detected cases vs. CRCs in unscreened people. Our findings support the implementation of FIT organised screening and the continued effort to increase uptake.

Keywords: colorectal cancer; cancer screening; incidence; mortality; impact; screen-detected cancer; interval cancer; survival (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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