Technical Report for the National Committee on Colorectal Cancer Screening
Table of Contents
Technical Report for the
National Committee on
Colorectal Cancer Screening
May 2002
136 pages
(1,447 KB) in PDF format ![PDF](../../gfx_common/pdficon.gif)
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](../../gfx_common/pdficon.gif)
[Population-based Colorectal Cancer
Screening]