Colorectal Screening Program in Northern Portugal: First Findings

Area of Science:

• Gastroenterology
• Public Health
• Oncology

Background:

• Colorectal cancer screening programs are cost-effective for individuals aged 50-74.
• This study reports initial findings from a population-based colorectal cancer screening program in Northern Portugal.
• The program utilizes faecal immunochemical testing (FIT) followed by colonoscopy.

Purpose of the Study:

• To evaluate the implementation of a population-based colorectal cancer screening program in Northern Portugal.
• To assess key performance indicators including uptake rate, FIT positivity, and diagnostic yield.
• To analyze the quality of colonoscopy procedures following positive FIT results.

Main Methods:

• A pilot phase involved direct mailing invitations and primary care center referrals.
• The first year of implementation assessed adherence, FIT positivity, and advanced neoplasia detection.
• Colonoscopy quality and adverse events were monitored post-FIT.

Main Results:

• Over 100,000 eligible subjects were invited; 29% adherence was observed in the first year.
• The FIT positivity rate was 5%, with a 60% compliance for follow-up colonoscopies.
• The detection rate for advanced neoplasia was 0.35/1000 subjects; positive predictive values were 44% for advanced adenoma and 2% for invasive cancer.

Conclusions:

• Suboptimal adherence to FIT and follow-up colonoscopy requires urgent attention.
• A centralized direct mailing invitation system proved feasible.
• Adequate colonoscopy quality and diagnostic yield suggest program success.