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©2009 The WJG Press and Baishideng.
World J Gastroenterol. Dec 21, 2009; 15(47): 5907-5915
Published online Dec 21, 2009. doi: 10.3748/wjg.15.5907
Published online Dec 21, 2009. doi: 10.3748/wjg.15.5907
Table 1 Colorectal cancer incidence in European countries in 2006
Parameter | Incidence |
Countries with the highest incidence | > 70/100 000 men (ASR-E): Hungary (106), Czech Republic (94.4), Slovakia (87.1), Switzerland (79.1), Germany (70.2) |
> 45/100 000 women (ASR-E): Switzerland (55.6), Norway (51.2), Hungary (50.6), Denmark (48), Czech Republic (46), Germany (45.1) | |
Countries with the lowest incidence | < 40/100 000 men (ASR-E): Albania (13.6), Greece (31), Bosnia Herzegovina (34.6), Republic of Moldova (38.7), Finland (39.2) |
< 26/100 000 women (ASR-E): Greece (21.3), Albania (21.4), Romania (25.1), Spain (25.4) |
Table 2 Colorectal cancer mortality in European countries in 2006
Parameter | Mortality |
Countries with the highest mortality | > 40/100 000 men (ASR-E): Hungary (54.4), Czech Republic (51), Slovakia (43.3), Croatia (40.7) |
> 20/100 000 women (ASR-E): Hungary (26.7), Slovakia (24.4), Czech Republic (24.1), Denmark (24.1), Norway (21.4) | |
Countries with the lowest mortality | < 20/100 000 men (ASR-E): Albania (7.3), Greece (15.5), Finland (17.9), Switzerland (19.1), Cyprus (19.3), Bosnia Herzegovina (19.5) |
< 12/100 000 women (ASR-E): Albania (9.9), Greece (10.8), Finland (11.3), Switzerland (11.6) |
Table 3 Epidemiology of colorectal cancer in the Europe (96 individual cancer registries, 1998-2002)
Parameter incidence | Sex | C18-C21 | Individual diagnoses | ||
C18 | C19-C20 | C21 | |||
Crude incidence (cases/100.000 inhabitants) | Men | 63.9 | 37.1 | 26.0 | 0.8 |
Women | 53.7 | 34.8 | 17.6 | 1.3 | |
All | 58.6 | 35.9 | 21.7 | 1.1 | |
ASR-E | Men | 58.0 | 33.5 | 23.7 | 0.8 |
Women | 36.8 | 23.4 | 12.4 | 1.0 | |
All | 45.8 | 27.6 | 17.3 | 0.9 | |
ASR-W | Men | 38.5 | 22.0 | 15.9 | 0.5 |
Women | 24.6 | 15.5 | 8.4 | 0.7 | |
All | 30.6 | 18.3 | 11.7 | 0.6 | |
Mean age (yr) | Men | 69.1 | 69.7 | 68.2 | 65.4 |
Women | 71.3 | 71.9 | 70.4 | 67.7 | |
All | 70.1 | 70.8 | 69.1 | 66.8 | |
Ratio (males: females) (based on No. of cases) | 1.1:1 | 1.0:1 | 1.4:1 | 0.6:1 |
Table 4 Five-year relative survival rate (RSR) for colorectal cancer for selected European countries
Country | Diagnoses | Assessment period | Five-year RSR (%) | Change in time (%) | Stage-specific estimates |
EUROCARE pool[7] | C18-C21 | 1995-1999 | 53.5 | 4.2 | NA |
EUROCARE pool[8] | C18-C21 | 2000-2002 | 56.2 | NA | NA |
England & Wales[10,11] | C18 | 1996-1999 | 47.6 M; 47.4 F | 5.6 M; 5.6 F | NA |
C19-C20 | 1996-1999 | 48.7 M; 51.3 F | 7.4 M; 8.1 F | NA | |
Germany[12] | C18-C21 | 2000-2002 | 60.8 | NA | 85.4 L; 58.1 R; 10.7 M |
Finland[13] | C18-C20 | 2000-2004 | 57.9 | 2.4 | NA |
Norway[14] | C18-C21 | 2000-2004 | 59.2 | 3.6 | NA |
Slovenia[15] | C18-C21 | 2000-2004 | 46.9 | 8.0 | NA |
Sweden[16] | C18 | 2000-2002 | 58.1 M; 59.7 F | 1.8 M; 2.6 F | NA |
C19-C21 | 2000-2002 | 57.5 M; 59.1 F | 2.5 M; -1.7 F | NA |
Table 5 Screening methods
Type of method | Method |
Stool tests | For presence of occult blood (FOBT) |
Guaiac-based (gFOBT) | |
Immunochemical (iFOBT) | |
For presence of abnormal DNA | |
Endoscopic examinations | Flexible sigmoidoscopy (FS) colonoscopy |
Radiologic examinations | Computed tomographic colonography (CTC) |
Double contrast barium enema (DCBE) |
Table 6 Colorectal cancer screening programs in 2007
Program | Test type | Screening interval years or times in LT | Age eligible national population | |||
Type | Status | Age (yr) | Persons (× 1000) | |||
Austria | NonPB | Natw | FOBT | 1 or 2 | > 50 | 2210 |
NonPB | Natw | CS | 10 | > 50 | 2210 | |
Belgium | No Prog | 2880 | ||||
Bulgaria | NonPB | Natw | FOBT | 1 | > 31 | 2340 |
Cyprus | PB | Natw-plan | FOBT | 1 in LT | 50 | 10 |
PB | Natw-plan | CS | 1 in LT | 55 | 10 | |
Czech Republic | NonPB | Natw | FOBT | 2 | > 50 | 3010 |
Denmark | No Prog | 1540 | ||||
Estonia | No Prog | 370 | ||||
Finland | PB | Natw-roll ong | FOBT | 2 | 60-69 | 570 |
France | PB | Natw-roll ong | FOBT | 2 | 50-74 | 16 600 |
Germany | NonPB | Natw | FOBT | 1 and 2 | > 50 | 24 500 |
NonPB | Natw | CS | 10 (2 in LT) | 55-74 | 18 800 | |
Greece | NonPB | Natw | FOBT | 5 | > 50 | 3180 |
NonPB | Natw | CS | 5 | > 50 | 3180 | |
Hungary | PB | Natw-pilot | FOBT | 2 | 50-70 | 2630 |
Ireland | No Prog | 940 | ||||
Italy | PB | Natw-roll ong | FOBT | 2 | 50-69 (70-75) | 13 800 |
PB | Reg-roll ong | FS | 1 in LT | 58 or 60 | 80 | |
Latvia | NonPB | Natw | FOBT | 1 | > 50 | 630 |
Lithuania | No Prog | 870 | ||||
Luxembourg | No Prog | 120 | ||||
Malta | No Prog | 120 | ||||
Netherlands | No Prog | 4460 | ||||
Poland | PB | Natw-roll ong | CS | 10 | 50-65 | 7500 |
Portugal | PB | Natw-plan | FOBT | 2 | 50-70 | 2520 |
Romania | PB | Natw-plan | FOBT | 2 | 50-74 | 5800 |
Slovak Republic | NonPB | Natw | FOBT | > 50 | 1360 | |
NonPB | Natw-plan | CS | 10 | > 50 | 1360 | |
Slovenia | PB | Natw-plan | FOBT | 2 | 50-69 | 490 |
Spain | PB | Reg-pilot | FOBT | 2 | 50-69 | 210 |
Sweden | PB | Reg-plan | FOBT | 2 | 60-69 | 220 |
UK | PB | Natw-roll ong | FOBT | 2 | (50) 60-69 (74) | 7600 |
Dual prog/test | -25 630 | |||||
Subtotal | 106 490 | |||||
Excluded pop. | 29 500 | |||||
Total | 135 990 |
Table 7 Cascade concept
Level | Average risk | High risk |
1 | Colonoscopy in 10 years interval, from 50 years of age | Special procedure, for individual groups |
2 | Colonoscopy once in a lifetime, at 50 years of age | Special procedure, for individual groups |
3 | Flexible sigmoidoscopy in 5 years interval, from 50 years of age; colonoscopy to follow if positive | Special procedure, for individual groups |
4 | Flexible sigmoidoscopy once in a lifetime, at 50 years of age; colonoscopy to follow if positive | Special procedure, for individual groups |
5 | Flexible sigmoidoscopy once in a lifetime, at 50 years of age; colonoscopy to follow only if advanced adenoma is detected | Same as individuals with average risk, if resources are not available for colonoscopy |
6 | FOBT in annual interval after 50 years of age; if positively tested, colonoscopy or double contrast barium enema | Same as individuals with average risk, if resources are not available for colonoscopy |
- Citation: Zavoral M, Suchanek S, Zavada F, Dusek L, Muzik J, Seifert B, Fric P. Colorectal cancer screening in Europe. World J Gastroenterol 2009; 15(47): 5907-5915
- URL: https://www.wjgnet.com/1007-9327/full/v15/i47/5907.htm
- DOI: https://dx.doi.org/10.3748/wjg.15.5907