PTU-049 Recent colorectal cancer incidence trends: is overdiagnosis a problem in screening?. (8th June 2018)

• Record Type: Journal Article
• Authors: Morling, Joanne; Chapman, Caroline; Logan, Richard
• Is Part Of: Gut. Volume 67(2018)Supplement 1
• Page Start: A196
• Page End: A196
• Publication Date: 2018-06-08
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2018-BSGAbstracts.390
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Introduction: Colorectal cancer (CRC) screening using biennial gFOBT was introduced in England in September 2006. 1 and by 2010 was being offered >90% of 60–69 year olds, rising to >95% of 60–74 year olds by 2014. Overdiagnosis of cancer is a major concern of cancer screening programmes; in breast cancer it has been estimated that around 50% of screen detected cancers might be due to overdiagnosis. This study seeks to examine the trends in CRC incidence and ascertain what impact screening has had on incidence. Methods: Data for the period 2001–16 was extracted from the ONS website (www.ons.gov.uk) and CRC incidence rates by 5 year age bands from age 45 calculated. CRC was defined according to the ICD 10th Revision codes C18 (colon) and C19/C20/C21 (rectum, recto-sigmoid and anus). Changes in incidence rates in age groups never offered screening were compared with those offered screening (age group 60–74 years). Results: As shown in table 1 CRC incidence in the 60–64 age band has increased, peaking at 22% (M) and 17% higher(F) in 2009/10 coinciding with the completion of screening roll-out before reducing somewhat. In the 65–69 age band there were similar peaks (21% M and 17% F) in 2008–10 before a decline to below pre-screening rates. In the 70–74 age band for whom screening started in 2010 there were peaks in 2011/12 (17% M and 19% F) before declining below pre-screening rates. These patterns were similar for both colon (C18) and for rectal (C19–21) cancers. Conclusion: At this point we could find no evidence of over diagnosis of CRC. While there has been a 13% increase in CRC incidence in the 60–64 age band, consistent with the first (prevalent) screening round there has been no sustained increase in the older age bands offered screening. In contrast there has been an increase in incidence of rectal cancer in women under age 60. Reference: . Logan RF, Patnick J, et al. Outcomes of the BCSP in England after the first 1 million tests. GUT2012Oct;61:1439–46.