Poskus Tomas, Strupas Kestutis, Mikalauskas Saulius, Bitinaitė Dominyka, Kavaliauskas Augustas, Samalavicius Narimantas E, Saladzinskas Zilvinas
aCentre of Abdominal Surgery bDepartment of Abdominal Surgery, National Cancer Institute, Vilnius University, Vilnius cDepartment of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Eur J Cancer Prev. 2015 Mar;24(2):76-80. doi: 10.1097/CEJ.0000000000000096.
The aim of the present study was to review the National Colorectal Cancer Screening Program (the Program) in Lithuania according to the criteria set by the European Union. In Lithuania, screening services are provided free of charge to the population. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the Program has its own administrative code. All the information about the performance of the Program is collected in one institution - the NHIF. The results of the Program were retrieved from the database of NHIF from the start of the Program from 1 July 2009 to 1 July 2012. Descriptive analysis of epidemiological indicators was carried out. Results were compared with the references in the guidelines of the European Union for quality assurance in colorectal cancer (CRC) screening and diagnosis. Information service [which involves fecal immunochemical test (FIT)] was provided to 271,396 of 890,309 50-74-year-old residents. The screening uptake was 46.0% over 3 years. During this period, 19,455 (7.2%) FITs were positive and 251,941 (92.8%) FITs were negative. Referral for colonoscopy was performed in 10,190 (52.4%) patients. Colonoscopy was performed in 12,864 (66.1%) patients. Colonoscopy did not indicate any pathological findings in 8613 (67.0%) patients. Biopsies were performed in 4251 (33.0%) patients. The rate of high-grade neoplasia reported by pathologists was 3.9%; the rate of cancer was 3.1% of all colonoscopies. The rate of CRC detected by the Program was 0.2%. The CRC screening program in Lithuania meets most of the requirements for standardized CRC screening programs. The invitation coverage and rate of referral for colonoscopy after positive FIT should be improved.
本研究的目的是根据欧盟设定的标准，对立陶宛的国家结直肠癌筛查计划（该计划）进行评估。在立陶宛，筛查服务是向民众免费提供的。国家健康保险基金（NHIF）会向提供每项服务的机构进行报销；该计划中的每个程序都有其自己的行政代码。关于该计划执行情况的所有信息都由一个机构——NHIF收集。该计划的结果是从NHIF的数据库中获取的，时间跨度为该计划从2009年7月1日开始至2012年7月1日。对流行病学指标进行了描述性分析。将结果与欧盟结直肠癌（CRC）筛查和诊断质量保证指南中的参考标准进行了比较。向890,309名50至74岁居民中的271,396人提供了信息服务[包括粪便免疫化学试验（FIT）]。3年期间的筛查接受率为46.0%。在此期间，19,455例（7.2%）FIT检测呈阳性，251,941例（92.8%）FIT检测呈阴性。10,190例（52.4%）患者被转诊进行结肠镜检查。12,864例（66.1%）患者接受了结肠镜检查。8613例（67.0%）患者的结肠镜检查未发现任何病理结果。4251例（33.0%）患者进行了活检。病理学家报告的高级别瘤变率为3.9%；在所有结肠镜检查中癌症发生率为3.1%。该计划检测到的CRC发生率为0.2%。立陶宛的CRC筛查计划符合标准化CRC筛查计划的大多数要求。FIT检测呈阳性后的结肠镜检查邀请覆盖率和转诊率应予以提高。
