ARCHIVED - Technical Report for the National Committee on Colorectal Cancer Screening

 

Table of Contents

Technical Report for the National Committee on Colorectal Cancer Screening
136 pages (1,447 KB) in PDF format PDF

 

Recommendations for Population-based Colorectal Cancer Screening

by the National Committee on Colorectal Cancer Screening, an expert panel

Introduction

Criteria for Development of Recommendations

  • Criterion 1: The condition should be an important health problem.
  • Criterion 2: The natural history of the condition, including development from latent to declared disease, must be understood. There should be a recognizable latent (asymptomatic) period or early symptomatic stage.
  • Criterion 3: There should be a suitable screening test or examination.
  • Criterion 4: The overall benefit of the screening program should outweigh the potential harms from its application.
  • Criterion 5: The test (inclusive of screening and diagnosis) should be acceptable to the population.
  • Criterion 6: Evidence-based recommendations should be available to identify who should be offered further diagnostic investigation and/or treatment, and the choices available to them.
  • Criterion 7: Treatment or intervention that improves survival or quality of life (compared with not screening) should be available for patients with recognized disease.
  • Criterion 8: Adequate staffing and facilities for recruitment, testing, diagnosis and follow-up, treatment, and program management should be available.
  • Criterion 9: The resources allocated to the screening program (including testing, diagnosis, and treatment of patients diagnosed) should be economically balanced in relation to other health care priorities.

Appendices

  • Appendix A: Terms of Reference
  • Appendix B: Primary Prevention of Colorectal Cancer
  • Appendix C: Screening for Colorectal Cancer Using the Fecal Occult Blood Test: Assessing the Impact of a Canadian Population-based Program Using an Actuarial Model
  • Appendix D: Modelling colorectal cancer screening in POHEM
  • Appendix E: Summary of key informant interviews regarding national capacity for colonoscopy as diagnostic follow-up to FOBT, for population-based colorectal cancer screening
  • Appendix F: Comparison of Three Randomized Controlled Trials of FOBT Screening for Colorectal Cancer

List of Tables

  • Table 1: Canadian Adaptation of the WHO Principles of Early Disease Detection
  • Table 2: Lifetime Probability of Developing or Dying from Colorectal, Lung, Breast and Prostate Cancer
  • Table 3: Potential Years of Life Lost Due to Colorectal, Lung, Breast, and Prostate Cancer, in Canada, 1997
  • Table 4: Relative Mortality Reduction (%) from CRC in the Minnesota, Funen and Nottingham trials
  • Table 5: Measures of FOBT Performance from RCTs: Sensitivity, Specificity, and Positive Predictive Value (as reported in the National Advisory Committee on Health and Disability)
  • Table 6: General Types of FOBT
  • Table 7: Underlying Assumptions for Population Health Model (POHEM)
  • Table 8: Impact of a 10 Year Annual and Biennial FOBT Screening Program, in Canada, Projected from the POHEM
  • Table 9: Reported Major Complication Rates with Colonoscopy and Polypectomy (post-procedure)
  • Table 10: Projected Number of Complications Resulting from Colonoscopy During a 10-year Screening Program, in Canada (from the POHEM)
  • Table 11: Individual Potential Gains/Risks from Full Participation in a Biennial CRC Screening Program, Starting at Age 50 and Stopping at Age 74
  • Table 12: Participation and Compliance Rates in Randomized Controlled Trials of FOBT
  • Table 13: Comparison of CRC Stage Distributions: Ottawa Regional Cancer Centre vs. US Surveillance Epidemiology and End Results (SEER) Program
  • Table 14: Five Year CRC Survival, by Stage (US SEER 1989-95)
  • Table 15: Estimated Number of Annual FOBTs Incurred in the First Year (2000) of a Biennial Screening Program, with 67% Participation (from POHEM)
  • Table 16: Estimated Number of Annual FOBTs Incurred in the First Year (2000) of a Biennial Screening Program, with 67% Participation rate achieved (ramped up) over 5 years (from POHEM)
  • Table 17: Projected Rates of Colonoscopy Procedures for the Year 2000 of a Biennial Screening Program, Based on Current Rates of Procedures (CIHI) and Modelling Projections (POHEM)
  • Table 18: Colonoscopy Cost Analysis (4 diagnostic colonoscopies) - Endoscopy Suite in P.E.I.
  • Table 19: Cost per Service for Colonoscopy, by Province, 1995/96 (CIHI, 2000)
  • Table 20: Estimated Costs of Screening Program Components for Core Scenario
  • Table 21: Estimated Costs of Screening Program Components for the Sensitivity Analyses
  • Table 22: Incremental Cost Per Life Year Gained with Biennial Screening Starting at Different Ages (ending at age 74)
  • Table 23: Incremental Cost Per Life Year Gained with Extending Screening to Different Ages (starting at age 50)

 

Technical Report for the
National Committee on
Colorectal Cancer Screening

May 2002

136 pages (1,447 KB) in PDF format  PDF

 

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