ESTIMATING THE EFFICIENCY OF THREE NATIONAL CANCER SCREENING PROGRAMMES USING THE POPULATION-BASED CANCER REGISTRY DATA IN SLOVENIA Vesna ZADNIK MD, PhD Slovenian Cancer Registry Institute of Oncology Ljubljana ww.slora.si/en www.onko-i.si/en/crs [email protected] BACKGROUND: SLOVENIA
SLOVENIA App: 20,000 km2 2 million inhabitants BACKGROUND: SLOVENIAN CANCER REGISTY General cancer registry Population-based Compulsory notification since 1950
PIN Follow-up through Central Population Registry Linkage to screening registries database BACKGROUND: CERVICAL CANCER SCREENING ZORA started 2003 conventional cytology 3 years interval age 2064 participation 72%
BACKGROUND: COLORECTAL CANCER SCREENING SVIT started 2009 immunochemical fecal occult blood test, follow up colonoscopy 2 years interval age 5074 participation 62% BACKGROUND: BREAST CANCER SCREENING
DORA started 2008 in central region, countrywide in 2018 digital mammography 2 years interval age 5069 participation 73% METHODS SCR data: C53, C18-C20, C50
INCIDENCE TREND: APC (before/after screening) SCR data linked to screening registries: 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 stage distribution 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 stage distribution 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 stage distribution DORA 100% 80% 60%
40% 20% 0% I II III
IV CONCLUSIONS 1. Slovenian population-based cancer registry database is adequate for estimating the efficiency of three national cancer screening programmes. 2. 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. 3. 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.
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