563P - The impact of participation in colorectal cancer screening: A population-based results from Lithuania

Background

Around 1.9 million new cancer cases and around 930,000 deaths were attributed to colorectal cancer (CRC) worldwide in 2020. The European Union recommends population-based CRC screening. Reported long‘term results from various CRC screening programs are quite controversial as some of them report no survival gains. In June 2009 the CRC screening program was initiated in Lithuania. The aim of the study is to report the impact of CRC screening program on long-term mortality.

Methods

The anonymous data of the population aged 50-74 from the years 2013 to 2019, who participated in the CRC screening program were extracted from the statistical database of the National Health Insurance Fund, which provided both, the participation in different services of screening indicated by specific codes, and the mortality and survival marked in the database. For statistical analysis we divided patients in three groups: Negative fecal immunochemical test (FIT); positive FIT and screening colonoscopy performed; positive FIT and screening colonoscopy was not performed. The statistical analysis was performed using the R statistical software package v4.2.2.

Results

From the year 2013 to 2019 a total of 1,521551 people participated in the screening program. During the observation period 66920 (4.4%) patients died. The highest mortality was seen in patients that were diagnosed with cancer (19%). High mortality was seen in patients that did not proceed with further colonoscopy after a positive FIT. These patients had a significantly higher mortality rate: Negative FIT (4.2%) vs. Positive FIT + colonoscopy (4.9%) vs. Positive FIT - colonoscopy (8.6%); p<0.001. A univariate logistic regression analysis revealed that positive FIT + colonoscopy (OR 1.19 95% CI 1.15-1.24; p<0.001) and positive FIT - colonoscopy (OR 2.18 95% CI 2.12-2.24; p<0.001) groups had significantly increased mortality risks when compared to the negative FIT group.

Conclusions

Fully completed screening after a positive FIT result is associated with significantly reduced mortality.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.