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Original article

Vol. 153 No. 4 (2023)

Colorectal cancer testing rates after implementation of an organised screening programme in Vaud, Switzerland

  • Christina Hempel-Bruder
  • Lamprini Syrogiannouli
  • Rémi Schneider
  • Sarah Bissig
  • Oliver Senn
  • Kali Tal
  • Jean-Luc Bulliard
  • Cyril Ducros
  • Christian P. R. Schmid
  • Reto Auer
  • Kevin Selby
DOI
https://doi.org/10.57187/smw.2023.40054
Cite this as:
Swiss Med Wkly. 2023;153:40054
Published
11.04.2023

Summary

AIMS OF THE STUDY: Canton Vaud, Switzerland, implemented an organised colorectal cancer  screening programme with colonoscopy and faecal occult blood tests in 2015, 4 to 6 years ahead of neighbouring cantons. Before its implementation, nearly half of Swiss citizens were already up to date with screening, primarily from opportunistic colonoscopies. We hypothesised that earlier implementation of an organised programme would be associated with greater increases in colorectal cancer testing rates.

METHODS: We analysed Swiss health insurance claim data from CSS, a Swiss health insurer covering 16% of the Swiss population and 10% of canton Vaud. We stratified 50–69-year-olds into groups from Vaud, its four neighbouring cantons (Fribourg, Geneva, Neuchâtel and Valais), and the rest of Switzerland. We analysed overall, faecal occult blood test and colonoscopy testing rates for each year between 2010 and 2018.

RESULTS: The overall testing rate increased from 7.6% in 2010 to 11.6% in 2018 (+4.0%) in Vaud, from 6.1% to 9.3% (+3.2%) in neighbouring cantons and from 7.4% to 8.6% (+1.2%) in the rest of Switzerland. The faecal occult blood test rate increased between 2016 and 2018 from 2.9% to 4.1% (+1.2%) in Vaud and from 1.7% to 2.6% (+0.9%) in neighbouring cantons, but it decreased from 3.1% to 1.5% (–1.6%) in the rest of Switzerland. The colonoscopy rate increased in all cantons, from 4.7% to 7.5% in Vaud (+2.8%), from 4.4% to 6.7% in neighbouring cantons (+2.3%) and from 4.3% to 7.1% in the rest of Switzerland (+2.8%). By 2018, 40% of faecal occult blood tests and 26% of colonoscopies in Vaud occurred in the organised programme. Those who completed an faecal occult blood test within the Vaud programme were younger, had fewer comorbidities and were more likely to have a high-deductible health plan than those tested outside the programme.

CONCLUSIONS: Colorectal cancer testing rates increased between 2010 and 2018, with greater absolute increases in Vaud than in neighbouring cantons or the rest of Switzerland. Faecal occult blood test use increased in both Vaud and neighbouring cantons, possibly reflecting changes in testing patterns by general practitioners. By 2018, 40% of colonoscopies and 26% of faecal occult blood tests occurred within the screening programme.

References

  1. Office Fédéral de la Statistique (OFS) . Le cancer en Suisse, rapport 2021. Available from: https://www.bfs.admin.ch/news/fr/2021-0245
  2. Bulliard JL , Ducros C , Levi F . Dépistage organisé du cancer colorectal: défis et enjeux pour un essai pilote en Suisse. Rev Med Suisse. 2012 Jul;8(348):1464–7.
  3. von Karsa L , Patnick J , Segnan N , Atkin W , Halloran S , Lansdorp-Vogelaar I , et al.; European Colorectal Cancer Screening Guidelines Working Group . European guidelines for quality assurance in colorectal cancer screening and diagnosis: overview and introduction to the full supplement publication. Endoscopy. 2013;45(1):51–9. DOI: https://doi.org/10.1055/s-0032-1325997
  4. Davidson KW , Barry MJ , Mangione CM , Cabana M , Caughey AB , Davis EM , et al.; US Preventive Services Task Force . Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021 May;325(19):1965–77. https://doi.org/10.1001/jama.2021.6238 DOI: https://doi.org/10.1001/jama.2021.6238
  5. Arditi C , Peytremann-Bridevaux I , Burnand B , Eckardt VF , Bytzer P , Agréus L , et al.; EPAGE II Study Group . Appropriateness of colonoscopy in Europe (EPAGE II). Screening for colorectal cancer. Endoscopy. 2009 Mar;41(3):200–8. https://doi.org/10.1055/s-0028-1119626 DOI: https://doi.org/10.1055/s-0028-1119626
  6. Braun AL , Kässner A , Syrogiannouli L , Selby K , Bulliard JL , Martin Y , et al. Association between colorectal cancer testing and insurance type: Evidence from the Swiss Health Interview Survey 2012. Prev Med Rep. 2020 May;19:101111. https://doi.org/10.1016/j.pmedr.2020.101111 DOI: https://doi.org/10.1016/j.pmedr.2020.101111
  7. Auer R , et al. Programme cantonal vaudois de dépistage du cancer colorectal: information et décision partagée., Revue médicale suisse, vol. 11, no. 2209-15, 2015.
  8. Basu P , et al. Status of implementation and organization of cancer screening in The European Union Member States—Summary results from the second European screening report, vol. 142, no. 1, pp. 44-56, 2018. https://doi.org/10.1002/ijc.31043 DOI: https://doi.org/10.1002/ijc.31043
  9. R. Schneider et al. Ten-year changes in colorectal cancer screening in Switzerland: the Swiss Health Interview Survey 2007, 2012 and 2017. Primary and Hospital Care 2021;21(Suppl.11). Poster presentation in SSMIG congress, 2021. DOI: https://doi.org/10.1016/S0016-5085(22)61637-8
  10. Département fédéral de l'intérieur. Ordonnance du DFI sur les prestations dans l'assurance obligatoire des soins en cas de maladie. 1995 (Etat le 1er février 2021).
  11. Stratégies nationales contre le cancer. Les standards nationaux de qualité pour le dépistage du cancer colorectal en Suisse. Personnes asymptomatiques sans risque élevé. In: Standards de qualité pour le dépistage du cancer colorectal en Suisse, 2020.
  12. Schneider R , Näpflin M , Syrogiannouli L , Bissig S , Tal K , Bulliard JL , et al. Change in Colorectal Cancer Tests Submitted for Reimbursement in Switzerland 2012-2018: Evidence from Claims Data of a Large Insurance. Int J Public Health. 2021 Oct;66:1604073. https://doi.org/10.3389/ijph.2021.1604073 DOI: https://doi.org/10.3389/ijph.2021.1604073
  13. Ligue contre le cancer. Le cancer du côlon et du rectum. Carcinome colorectal. Informations de la Ligue contre le cancer pour les personnes touchées et leurs proches. 2e édition revue et augmentée, 2015.
  14. Swiss Confderation (2011). Federal Act on Research involving Human Beings. https://www.fedlex.admin.ch/eli/cc/2013/617/en
  15. Bissig S , Syrogiannouli L , Schneider R , Tal K , Selby K , Del Giovane C , et al. Change in colorectal cancer (CRC) testing rates associated with the introduction of the first organized screening program in canton Uri, Switzerland: evidence from insurance claims data analyses from 2010 to 2018. Prev Med Rep. 2022 Jun;28:101851. https://doi.org/10.1016/j.pmedr.2022.101851 DOI: https://doi.org/10.1016/j.pmedr.2022.101851
  16. CSS assurance. Rapport de gestion 2019. Groupe CSS Rapport de gestion, 2019, p. 13.
  17. Fischer R , Collet TH , Zeller A , Zimmerli L , Gaspoz JM , Giraudon K , et al. Obesity and overweight associated with lower rates of colorectal cancer screening in Switzerland. Eur J Cancer Prev. 2013 Sep;22(5):425–30. https://doi.org/10.1097/CEJ.0b013e32835f3b87 DOI: https://doi.org/10.1097/CEJ.0b013e32835f3b87
  18. Marbet UA , Bauerfeind P , Brunner J , Dorta G , Valloton JJ , Delcò F . Colonoscopy is the preferred colorectal cancer screening method in a population-based program. Endoscopy. 2008 Aug;40(8):650–5. https://doi.org/10.1055/s-2008-1077350 DOI: https://doi.org/10.1055/s-2008-1077350
  19. Lamers LM . Pharmacy costs groups: a risk-adjuster for capitation payments based on the use of prescribed drugs. Med Care. 1999 Aug;37(8):824–30. https://doi.org/10.1097/00005650-199908000-00012 DOI: https://doi.org/10.1097/00005650-199908000-00012
  20. Lamers LM , van Vliet RC . The Pharmacy-based Cost Group model: validating and adjusting the classification of medications for chronic conditions to the Dutch situation. Health Policy. 2004 Apr;68(1):113–21. https://doi.org/10.1016/j.healthpol.2003.09.001 DOI: https://doi.org/10.1016/j.healthpol.2003.09.001
  21. Lamers LM , Vliet RC . Health-based risk adjustment Improving the pharmacy-based cost group model to reduce gaming possibilities. Eur J Health Econ. 2003;4(2):107–14. https://doi.org/10.1007/s10198-002-0159-9 DOI: https://doi.org/10.1007/s10198-002-0159-9
  22. Cancer Care Ontario . Ontario Cancer Screening Performance. Report 2016. Toronto: Cancer Care Ontario; 2016.
  23. Braun AL , et al. Variation in colorectal cancer testing between primary care physicians: a cross-sectional study in Switzerland, vol. 64, no. 7, pp. 1075-1083, 2019. DOI: https://doi.org/10.1007/s00038-019-01259-4
  24. Segnan JP . L von Karsa , European Guidelines for Quality Assurance in Colorectal cancer screening and diagnosis - first edition. European comission, 2010.
  25. Chen C , Stock C , Jansen L , Chang-Claude J , Hoffmeister M , Brenner H . Trends in colonoscopy and fecal occult blood test use after the introduction of dual screening offers in Germany: results from a large population-based study, 2003-2016. Prev Med. 2019 Jun;123:333–40. https://doi.org/10.1016/j.ypmed.2019.03.048 DOI: https://doi.org/10.1016/j.ypmed.2019.03.048
  26. DeGroff A , Sharma K , Satsangi A , Kenney K , Joseph D , Ross K , et al. Increasing Colorectal Cancer Screening in Health Care Systems Using Evidence-Based Interventions. Prev Chronic Dis. 2018 Aug;15:E100. https://doi.org/10.5888/pcd15.180029 DOI: https://doi.org/10.5888/pcd15.180029
  27. Cardoso R , Guo F , Heisser T , Hoffmeister M , Brenner H . Utilisation of colorectal cancer screening tests in european countries by type of screening offer: results from the european health interview survey. Cancers (Basel). 2020 May;12(6):1409. https://doi.org/10.3390/cancers12061409 DOI: https://doi.org/10.3390/cancers12061409
  28. Selby K , Jensen CD , Levin TR , Lee JK , Schottinger JE , Zhao WK , et al. Program Components and Results From an Organized Colorectal Cancer Screening Program Using Annual Fecal Immunochemical Testing. Clin Gastroenterol Hepatol. 2022 Jan;20(1):145–52. https://doi.org/10.1016/j.cgh.2020.09.042 DOI: https://doi.org/10.1016/j.cgh.2020.09.042
  29. PharmaSuisse . (2019). Analyse de la prestation «Dépistage du cancer du côlon» réalisée par les pharmacies affiliées à pharmaSuisse. https://www.pharmasuisse.org/data/docs/fr/20985/190320-Datenerhebung-Darmkrebsvorsorge-2018.pdf?v=1.0
  30. Gimeno García AZ . Factors influencing colorectal cancer screening participation. Gastroenterol Res Pract. 2012;2012:483417. https://doi.org/10.1155/2012/483417 DOI: https://doi.org/10.1155/2012/483417

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