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This study evaluates the efficiency of three national cancer screening programs in Slovenia using population-based cancer registry data. The results show a decrease in cervical and colorectal cancer incidence, improved net survival rates, and early stage distribution in screened populations. The Slovenian Cancer Registry database proves to be an adequate tool for estimating the effectiveness of these screening programs.
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ESTIMATING THE EFFICIENCY OF THREE NATIONAL CANCER SCREENING PROGRAMMES USING THE POPULATION-BASED CANCER REGISTRY DATA IN SLOVENIA Vesna ZADNIK MD, PhD Slovenian CancerRegistry Institute of Oncology Ljubljana ww.slora.si/en www.onko-i.si/en/crs vzadnik@onko-i.si
BACKGROUND: SLOVENIA SLOVENIA App: 20,000 km2 2 million inhabitants
BACKGROUND: SLOVENIAN CANCER REGISTY • General cancerregistry • Population-based • Compulsory notificationsince 1950 PIN • Follow-up through Central Population Registry • Linkage to screeningregistriesdatabase
BACKGROUND: CERVICAL CANCER SCREENING ZORA • started 2003 • conventional cytology • 3 years interval • age 20–64 • participation 72%
BACKGROUND: COLORECTAL CANCER SCREENING SVIT • started 2009 • immunochemical fecal occult blood test, follow up colonoscopy • 2years interval • age 50–74 • participation 62%
BACKGROUND: BREAST CANCER SCREENING DORA • started 2008 in central region, countrywide in 2018 • digitalmammography • 2years interval • age 50–69 • participation 73%
METHODS SCR data: C53, C18-C20, C50 INCIDENCE TREND: APC (before/afterscreening) SCR data linked to screeningregistries: ATTENDANCE analysis of screened age groups NET SURVIVAL (screend/non-screened) RISK OF DYING (screend/non-screened) STAGE DISTRIBUTION (screend/non-screened)
RESULTS: CERVICAL CANCER SCREENING incidence trend ZORA • Fifteen years after ZORA started, the incidence of cervical cancer has decreased for more than 50%
RESULTS: CERVICAL CANCER SCREENING net survival ZORA • 5-yeat net survival: • SCREENED / NON-SCREENED • 92.1% / 63.7% • HR: • SCREENED / NON-SCREENED • 0.18 (0.11 – 0.28)
RESULTS: CERVICAL CANCER SCREENING stagedistribution ZORA
RESULTS: COLORECTAL CANCER SCREENING incidence trend SVIT • APC-males: • 2001-2010: + 7.6% • 2010-2015: - 5.2% • APC-females: • 2001-2010: + 3.9% • 2010-2015: - 4.5%
RESULTS: COLORECTAL CANCER SCREENING net survival SVIT • 5-yeat net survival: • SCREENED / NON-SCREENED • 88.4% /57.1% • HR: • SCREENED / NON-SCREENED • 0.26 (0.23-0.29)
RESULTS: COLORECTAL CANCER SCREENING stagedistribution SVIT
BACKGROUND: BREAST CANCER SCREENING net survival DORA • 5-yeat net survival: • SCREENED / NON-SCREENED • 100% /89% • HR: • SCREENED / NON-SCREENED • HR 0.17 (0.10-0.31).
BACKGROUND: BREAST CANCER SCREENING stagedistribution DORA
CONCLUSIONS Slovenian population-based cancer registrydatabase is adequateforestimating the efficiency of three national cancer screening programmes. Soon after the introduction of organised cancer screenings in Slovenia the two basic cancer burden indicators incidence and survival have improved dramatically. Pts with screen detected cancers are diagnosed in earlier stages and have lower probability to die from cancer. The two presented and many other cancer burden indicators reported by the PBCRs are (also in Slovenia) most important for planning and evaluation of national cancer screening programmes.