Article Text
Abstract
Introduction RCTs have demonstrated CRC screening efficacy. However, programme implementation requires substantial resources. Reliable estimates of the potential screening impact in a population would facilitate timely decisions about establishing programmes. Many countries lack the capacity and detailed knowledge of the distribution of the disease in the population for complex modelling, particularly medium-resource countries. Simple methods for estimating the future impact of CRC screening in such settings would be a useful tool in cancer control planning.
Methods For the 27 EU countries, population projections by country, sex and quinquennium were obtained from the UNpopin database. Country-, sex- and age-specific mortality rates were obtained from GLOBOCAN2002. The method requires stating parameters for the following factors: screening interval, age at screening attendance, participation rate and programme duration. Estimates for these parameters were derived from FOBt RCT results; simultaneous programme introduction throughout a country and high quality management were assumed.
Results 600 000 to 1.05 million CRC deaths could be avoided over 25 years in the EU depending on the screening interval and compliance rate, for programmes offered to the 50–74-year-old population.
Conclusions A method for estimating the population impact of CRC screening has been developed which requires minimum epidemiologic and technical support. The accuracy of the method should be assessed by comparing these preliminary results with sophisticated modelling approaches and with up-to-date estimates of CRC burden in populations in which screening coverage is known. Countries contemplating CRC screening, but lacking detailed knowledge of the disease burden, should develop this capacity in the early translational phase of programme planning.