The Performance of Colorectal Cancer Screening in Brazil: The First Two Years of the Implementation Program in Barretos Cancer Hospital

Author(s):Show less -

Guimaraes, Denise Peixoto ^{[1, 2, 3]} ; Mantuan, Larissa Andreoli ^[1] ; de Oliveira, Marco Antonio ^[4] ; Haikel Junior, Raphael Luiz ^[3] ; Costa, Allini Mafra ^[5] ; Rossi, Silvana ^[2] ; Fava, Gilberto ^[2] ; Taveira, Leonardo Nogueira ^[2] ; Giardina, Kelly Menezio ^[2] ; Talarico, Thais ^[1] ; Costa, Maraisa ^[1] ; Scapulatempo-Neto, Cristovam ^[6] ; Matsushita, Marcus M. ^[6] ; Rodrigues Veo, Carlos Augusto ^[7] ; Tavares Fregnani, Jose Humberto ^[1] ; Reis, Rui Manuel ^{[8, 1, 9]} ; Hawk, Ernest T. ^[10] ; Mauad, Edmundo Carvalho ^[3]

Affiliation

^[1] Barretos Canc Hosp, Mol Oncol Res Ctr, Barretos - Brazil

^[2] Barretos Canc Hosp, Dept Endoscopy, Barretos - Brazil

^[3] Barretos Canc Hosp, Dept Prevent, Antenor Duarte Villela 1331, BR-14784400 Barretos, SP - Brazil

^[4] Barretos Canc Hosp, Nucleous Epidemiol & Stat, Barretos - Brazil

^[5] Barretos Canc Hosp, Canc Registry, Barretos - Brazil

^[6] Barretos Canc Hosp, Dept Pathol, Barretos - Brazil

^[7] Barretos Canc Hosp, Dept Lower Digest Surg, Barretos - Brazil

^[8] ICVS 3Bs PT Govt Associate Lab, Braga - Portugal

^[9] Univ Minho, Sch Med, Life & Hlth Sci Res Inst ICVS, Braga - Portugal

^[10] Univ Texas MD Anderson Canc Ctr, Canc Prevent & Populat Sci, Houston, TX 77030 - USA

• Document type: Journal article
• Source: Cancer Prevention Research; v. 14, n. 2, p. 241-251, FEB 2021.
• Web of Science Citations: 1

Abstract

Colorectal cancer is the second most common cancer in Brazil. Yet, a nationally organized colorectal screening program is not implemented. Barretos Cancer Hospital (BCH) is one of the largest Brazilian institution that cares for underserved patients. BCH developed a fecal immunochemical test (FIT)-based organized colorectal cancer screening program to improve colorectal cancer outcomes. This study aims to present the quality/performance measures of the first 2 years of the FIT-based colorectal cancer screening program and its impact on the colorectal cancer disease stage. Between 2015 and 2017, a total of 6,737 individuals attending the Outpatient Department of Prevention or the Mobile Unit of BCH, which visits 18 cities of Barretos county, ages 50 to 65 years, were personally invited by a health agent/nurse practitioner. Exclusion criteria were personal history of colorectal cancer, adenomatous polyps, inflammatory bowel disease, and colonoscopy, or flexible sigmoidoscopy performed in the past 5 years. European Union (EU) guidelines for colorectal cancer screening programs were evaluated. Overall, 92.8% returned the FIT, with an inadequate examination rate of 1.5%. Among the 6,253 adequately tested, 12.5% had a positive result. The colonoscopy compliance and completion rates were 84.6 and 98.2%, respectively. The PPVs were 60.0%, 16.5%, and 5.6% for adenoma, advanced adenoma, and cancer, respectively. Stage distribution of screen-detected cancers shows earlier stages than clinically diagnosed colorectal cancer cancers reported at BCH and Brazilian cancer registries. Our colorectal cancer screening program achieved desirable quality metrics, aligned with the EU guidelines. The observed shift toward earlier colorectal cancer stages suggests an exciting opportunity to improve colorectal cancer-related cancers in Brazil. (AU)

• FAPESP's process: 18/22097-0 - Malignant neoplasms of the 18 cities of Barretos Regional Health District (RhD), Sao Paulo, Brazil: the importance of a population-based cancer registry
• Grantee: Allini Mafra da Costa
• Support Opportunities: Scholarships in Brazil - Post-Doctoral