Purpose

The effectiveness of the Colorectal Cancer (CRC) screening program is assessed based on the reduction in CRC mortality and incidence rates over time. To accurately estimate the long-term impact, it is advisable to monitor additional indicators such as age and stage-specific incidence rates. Our objective is to evaluate the effectiveness of the National CRC Screening Program in Turkey and analyze its influence on disease stage at diagnosis and survival rates.

Methods

The National CRC Screening Program was considered an intervention and the distribution of local, regional, and distant diseases, and survival estimates were assessed before and after the intervention to evaluate the effectiveness of the intervention.

Results

518 patients were included in the study. At the time of diagnosis, localized, regional, and distant disease in pre-intervention were 31.3%, 42.9%, 25.8%, while post-intervention were 42.8%, 33.3%, 23.9%, respectively (p = 0.020). The relative effectiveness of the intervention in males, females, and 50–70 ages were calculated as 1.2[95% CI 0.95–1.73], 1.5[95% CI 1.04–2.18], and 1.6[95% CI 1.21–2.28] in localized disease, 0.8[95% CI 0.67–1.18], 0.6[95% CI 0.43–0.90], and 0.6[95% CI 0.46–0.81] in regional diseases, 0.8[95% CI 0.57–1.20], 1.1[95% CI 0.66–1.84], and 1.0[95% CI 0.70–1.57] in distant disease, respectively.

Conclusion

A noticeable shift in the disease stage at the time of diagnosis was observed; however, this shift varied among gender and age groups. To effectively evaluate the impact of a cancer screening program on reducing the incidence and mortality rates of the disease, it is essential to monitor and analyze these indicators alongside 5–10-year survival estimates and stage changes at the time of diagnosis.

中文翻译：

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结直肠癌筛查干预效果评价

目的

结直肠癌 (CRC) 筛查计划的有效性是根据结直肠癌死亡率和发病率随时间的降低情况进行评估的。为了准确估计长期影响，建议监测其他指标，例如年龄和特定阶段的发病率。我们的目标是评估土耳其国家结直肠癌筛查计划的有效性，并分析其对疾病阶段诊断和生存率的影响。

方法

国家CRC筛查计划被认为是一项干预措施，并在干预前后评估了局部、区域和远处疾病的分布情况，并评估了生存率估计，以评价干预措施的有效性。

结果

该研究纳入了 518 名患者。诊断时，干预前局部、区域和远处疾病的比例分别为 31.3%、42.9%、25.8%，而干预后分别为 42.8%、33.3%、23.9%（p  = 0.020）。男性、女性和 50-70 岁年龄段的干预相对有效性计算为 1.2[95% CI 0.95-1.73]、1.5[95% CI 1.04-2.18] 和 1.6[95% CI 1.21-2.28]局部疾病，0.8[95% CI 0.67–1.18]、0.6[95% CI 0.43–0.90]和 0.6[95% CI 0.46–0.81] 局部疾病，0.8[95% CI 0.57–1.20]、1.1[95远处疾病的 % CI 0.66–1.84] 和 1.0[95% CI 0.70–1.57] 分别。

结论

诊断时观察到疾病阶段发生明显转变；然而，这种转变因性别和年龄组而异。为了有效评估癌症筛查计划对降低疾病发病率和死亡率的影响，必须监测和分析这些指标以及诊断时的 5-10 年生存率估计和分期变化。