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Leja M. Where are we with gastric cancer screening in Europe in 2024? Gut 2024:gutjnl-2024-332705. [PMID: 39237127 DOI: 10.1136/gutjnl-2024-332705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 08/14/2024] [Indexed: 09/07/2024]
Abstract
The absolute number of annual cases of gastric cancer in Europe is rising. The Council of the European Union has recommended implementation of gastric cancer screening for countries or regions with a high gastric cancer incidence and death rates. However, as of 2024 no organised gastric cancer screening programme has been launched in Europe.There are several ways to decrease gastric cancer burden, but the screen and treat strategy for Helicobacter pylori (H. pylori) seems to be the most appropriate for Europe. It has to be noted that increased use of antibiotics would be associated with this strategy.Only organised population-based cancer screening is recommended in the European Union, therefore gastric cancer screening also is expected to fulfil the criteria of an organised screening programme. In this respect, several aspects of screening organisation need to be considered before full implementation of gastric cancer prevention in Europe; the age range of the target group, test types, H. pylori eradication regimens and surveillance strategies are among them. Currently, ongoing projects (GISTAR, EUROHELICAN, TOGAS and EUCanScreen) are expected to provide the missing evidence. Feedback from the decision-makers and the potential target groups, including vulnerable populations, will be important to planning the programme.This paper provides an overview of the recent decisions of the European authorities, the progress towards gastric cancer implementation in Europe and expected challenges. Finally, a potential algorithm for gastric cancer screening in Europe is proposed.
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Affiliation(s)
- Mārcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
- Department of Gastroenterology, Digestive Diseases Centre GASTRO, Riga, Latvia
- Department of Research, Riga East University Hospital, Riga, Latvia
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Sung JJY, Luk AKC, Ng SSM, Ng ACF, Chiu PKF, Chan EYY, Cheung PSY, Chu WCW, Wong SH, Lam TYT, Wong SYS. Effectiveness of One-Stop Screening for Colorectal, Breast, and Prostate Cancers: A Population-Based Feasibility Study. Front Oncol 2021; 11:631666. [PMID: 33718212 PMCID: PMC7948441 DOI: 10.3389/fonc.2021.631666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/11/2021] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer (CRC), prostate cancer (PC) and breast cancer (BC) are among the most common cancers worldwide with well-established screening strategies. We aim to investigate the effectiveness and compliance of a one-stop screening service for CRC, PC and BC. Asymptomatic subjects aged 50–75 years were invited. Eligible subjects were offered fecal immunochemical test (FIT) for CRC screening. Serum prostate specific antigen (PSA) and Prostate Health Index (PHI) were offered for male PC screening and mammogram (MMG) for female BC screening as a one-stop service. Colonoscopy was offered to FIT+ subjects, prostate biopsy to PSA/PHI+ (PSA>10/PHI≥35) males and breast biopsy to MMG+ (Breast Imaging-Reporting and Data System, BI-RADS≥4) females. From August 2018 to April 2020, 3165 subjects were recruited. All participants (1372 men and 1793 women) were willing to accept FIT for CRC screening, and PSA/PHI test or MMG as second cancer screening. 102 subjects diagnosed advanced neoplasms after colonoscopy. Thirty-three males diagnosed PC after prostate biopsy and 15 females diagnosed BC after breast biopsy. No major complication reported in first tier screening tests. Subjects who were willing to undergo CRC screening were highly likely to accept other cancer screening when offered in a one-stop program. In conclusion, the effectiveness and compliance of a one-stop service for CRC, PC, and BC screening among asymptomatic subjects were high. Future studies should be conducted to test various ways of integrating cancer screening programs.
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Affiliation(s)
- Joseph J Y Sung
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Arthur K C Luk
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Simon S M Ng
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Anthony C F Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Peter K F Chiu
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Emily Y Y Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | | | - Winnie C W Chu
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Sunny H Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Thomas Y T Lam
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Mema SC, Yang H, Vaska M, Elnitsky S, Jiang Z. Integrated Cancer Screening Performance Indicators: A Systematic Review. PLoS One 2016; 11:e0161187. [PMID: 27518708 PMCID: PMC4982666 DOI: 10.1371/journal.pone.0161187] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/01/2016] [Indexed: 12/30/2022] Open
Abstract
Cancer screening guidelines recommend that women over 50 years regularly be screened for breast, cervical and colorectal cancers. Population-based screening programs use performance indicators to monitor uptake for each type of cancer screening, but integrated measures of adherence across multiple screenings are rarely reported. Integrated measures of adherence that combine the three cancers cannot be inferred from measures of screening uptake of each cancer alone; nevertheless, they can help discern the proportion of women who, having received one or two types of screening, may be more amenable to receiving one additional screen, compared to those who haven't had any screening and may experience barriers to access screening such as distance, language, and so on. The focus of our search was to identify indicators of participation in the three cancers, therefore our search strategy included synonyms of integrated screening, cervical, breast and colorectal cancer screening. Additionally, we limited our search to studies published between 2000 and 2015, written in English, and pertaining to females over 50 years of age. The following databases were searched: MEDLINE, EMBASE, EBM Reviews, PubMed, PubMed Central, CINAHL, and Nursing Reference Center, as well as grey literature resources. Of the 78 initially retrieved articles, only 7 reported summary measures of screening across the three cancers. Overall, adherence to cervical, breast and colorectal cancer screening ranged from around 8% to 43%. Our review confirms that reports of screening adherence across breast, cervical and colorectal cancers are rare. This is surprising, as integrated cancer screening measures can provide additional insight into the needs of the target population that can help craft strategies to improve adherence to all three screenings.
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Affiliation(s)
- Silvina C. Mema
- Interior Health Authority, Kelowna, British Columbia, Canada
| | - Huiming Yang
- Alberta Health Services, Calgary, Alberta, Canada
| | - Marcus Vaska
- Alberta Health Services, Calgary, Alberta, Canada
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Association of diagnostic work-up with subsequent attendance in a breast cancer screening program for false-positive cases. Breast Cancer Res Treat 2010; 127:221-8. [PMID: 20809364 DOI: 10.1007/s10549-010-1118-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Accepted: 08/06/2010] [Indexed: 10/19/2022]
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Howard DH, Richardson LC, Thorpe KE. Cancer Screening And Age In The United States And Europe. Health Aff (Millwood) 2009; 28:1838-47. [DOI: 10.1377/hlthaff.28.6.1838] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | | | - Kenneth E. Thorpe
- Department of Health Policy and Management, Rollins School of Public Health, at Emory University in Atlanta, Georgia
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Billette-de-Villemeur A, Poncet F, Garnier A, Marron J, Le Marc’hadour F, Morens A, Rouault-Plantaz V, Ney M, Exbrayat C. Évaluation de la prise en charge des femmes de 50 à 74 ans après frottis du col de l’utérus répondu Ascus dans un dépistage organisé en Isère 1991–2000 : application de la conduite à tenir de l’Agence nationale d’accréditation et d’évaluation en santé. ACTA ACUST UNITED AC 2009; 37:787-95. [DOI: 10.1016/j.gyobfe.2009.04.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 04/02/2009] [Indexed: 12/01/2022]
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Seigneurin A, Exbrayat C, Labarère J, Colonna M. Comparison of interval breast cancer rates for two-versus single-view screening mammography: a population-based study. Breast 2009; 18:284-8. [PMID: 19713113 DOI: 10.1016/j.breast.2009.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 07/30/2009] [Accepted: 07/31/2009] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To determine whether the implementation of two-view mammography was followed by a reduction in the rates of interval cancers. MATERIAL AND METHOD We analyzed the data concerning women aged 50-69 who attended the breast cancer screening program between January 1, 1994 and December 31, 2006 in Isère, France. We performed Poisson regressions to estimate age-adjusted rate ratios of women being recalled, cancer detection, and interval cancer for two-view compared to single-view mammography. RESULTS After adjusting for age, two-view mammography was associated with a higher risk of cancer detection (1.37 [95% CI, 1.16-1.62]) and with a decreased risk of 12-month (0.46 [95% CI, 0.23-0.92]) and 24-month (0.64 [95% CI, 0.46-0.88]) interval cancer. CONCLUSION Two-view mammography for first and subsequent screens is associated with lower rates of interval breast cancer. This is at the expense of an increased number of women being recalled for further assessment after subsequent screens.
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Affiliation(s)
- A Seigneurin
- Registre du Cancer de l'Isère, 23 Chemin des Sources, Meylan, France.
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Garnier A, Poncet F, Billette De Villemeur A, Exbrayat C, Bon MF, Chevalier A, Salicru B, Tournegros JM. [Sensitivity and specificity of the breast screening program in the Isere region based on positive results between 1991 and 1999]. JOURNAL DE RADIOLOGIE 2009; 90:707-714. [PMID: 19623123 DOI: 10.1016/s0221-0363(09)74725-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE The screening program guidelines specify that the call back rate of women for additional imaging (positive mammogram) should not exceed 7% at initial screening, and 5% at subsequent screening. Materials and methods. Results in the Isere region (12%) have prompted a review of the correlation between the call back rate and indicators of quality (detection rate, sensitivity, specificity, positive predictive value) for the radiologists providing interpretations during that time period. RESULTS Three groups of radiologists were identified: the group with call back rate of 10% achieved the best results (sensitivity: 92%, detection rate: 0.53%, specificity: 90%). The group with lowest call back rate (7.7%) showed insufficient sensitivity (58%). The last group with call back rate of 18.3%, showed no improvement in sensitivity (82%) and detection rate (0.53%), but showed reduced specificity (82%). CONCLUSION The protocol update in 2001 does not resolve this problematic situation and national results continue to demonstrate a high percentage of positive screening mammograms. A significant increase in the number of positive screening examinations compared to recommended guidelines is not advantageous and leads to an overall decrease in the quality of the screening.
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Affiliation(s)
- A Garnier
- Office De Lutte contre le Cancer, 7, av du Granier, 38240 Meylan.
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