Impact of screening programme using the faecal immunochemical test on stage of colorectal cancer: Results from the IMPATTO study

Walter Mazzucco, Massimo Vicentini, Maria Gentilini, Manuel Zorzi, Alberto Azzoni, Luigi Bisanti, Pietro Seghini, Emanuela Bovo, Orietta Giuliani, Emanuela Anghinoni, Morena Malaspina, Marine Castaing, Roberto Rizzello, Adriano Giacomin, Natalina Collina, Teresa Intrieri, Riccardo Pertile, Francesco Tisano, Stefano Ferretti, Rosa FilibertiGiuliano Carrozzi, Claudia Casella, Claudia Casella, Anna Turrin, Grazia Grazzini, Flavio Sensi, Stefania Caroli, Enrica Tidone, Anna Clara Fanetti, Paola Pesce, Anna Rita Silvestri, Rosanna Cusimano, Sabina Malignaggi, Chiara Petrucci, Grazia Grazzini, Claudia Casella, Antonella Ippolito, Elisabetta Borciani, Pamela Mancuso, Massimo Varvarã , Simonetta Curatella, Paolo Giorgi Rossi, Mario Fusco, Antonio Colanino Ziino, Fabio Pannozzo, Stefano Ferretti, Fabio Falcini, Fabio Falcini, Anna Clara Fanetti, Massimo Rugge, Paola Mantellini, Gianfranco Manneschi, Guido Passanisi, Teresa Interieri, Antonella Ippolito, Maria Francesca Vitale, Adele Caldarella, Caterina Palmonari, Paolo Giorgi Rossi, Mario Fusco, Lorella Cecconami, Caterina Palmonari, Fabio Falcini, Caterina Palmonari, Paolo Giorgi Rossi, Adriano Giacomin, Paolo Sgargi, Rosaria Cesaraccio, Francesca Calabretta, Paola Bellardini, Aldo De Togni, Cinzia Campari, Fabrizio Stracci, Carlo Senore, Paola Mantellini, Lucia Mangone, Silvano Piffer, Antonella Puppo, Massimo Rugge, Claudia Casella, Fabio Falcini, Diego Serraino, Marco Zappa, Antonio Giampiero Russo, Maria Michiara, Antonio Gabriele Russo, Concetta Petrucci, Elena Maria Fusco, Matilde Vicentini

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11 Citations (Scopus)

Abstract

To evaluate the impact of faecal immunochemical test (FIT) screening on stage distribution at diagnosis, and to estimate relative incidence rates by stage in screened at first and subsequent rounds vs. unscreened. We included all incident cases occurring in 2000–2008 in 50- to 71-year-olds residing in areas with an FIT-screening programme. Multinomial logistic models were computed to estimate the relative risk ratio (RRR) of stages I and IV, compared to stage II + III, adjusting for age, sex, geographical area, and incidence year. Proportions were then used to estimate incidence rate ratios (IRR) by stage for screened subjects at the first and at subsequent rounds vs. unscreened subjects, applying the expected changes in overall incidence during screening phases. 11,663 cancers were included: 5965 in not-invited and 5,698 in invited subjects, 3,425 of whom attendees. Compared to not-invited, invited subjects had RRR 2.04 (95% CI: 1.84; 2.46) of stage I and RRR 0.77 (95% CI: 0.69; 0.87) of stage IV. Differences were stronger comparing attendees vs. nonattendees. Interval cancers were more frequently stage I compared to non-invited (RRR 1.54; 95% CI: 1.15; 2.04), but there was no difference for stage IV. IRRs in screened at first round vs. unscreened were 4.6 (95% CI: 4.2; 5.1), 1.4 (95% CI: 1.3; 1.5) and 0.7 (95% CI: 0.6; 0.9) for stages I, II + III and IV, respectively; in the following rounds the IRRs of screened vs. unscreened were 1.4 (95% CI: 1.2; 1.6), 0.8 (95% CI: 0.7; 0.9) and 0.3 (95% CI: 0.1; 0.4) for stages I, II + III and IV, respectively. FIT screening reduces the incidence of metastatic cancers by about 70% after the first round.
Original languageEnglish
Pages (from-to)110-121
Number of pages12
JournalInternational Journal of Cancer
Volume145
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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