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Cancer Prevention Research
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Research Article

The performance of colorectal cancer screening in Brazil: the first two years of the implementation program in Barretos Cancer Hospital

Denise Peixoto Guimarães, Larissa Andreoli Mantuan, Marco Antonio de Oliveira, Raphael Luiz Haikel Junior, Allini Mafra da Costa, Silvana Rossi, Gilberto Fava, Leonardo Nogueira Taveira, Kelly Menezio Giardina, Thais Talarico, Maraisa Costa, Cristovam Scapulatempo-Neto, Marcus M Matsushita, Carlos Augusto Rodrigues Véo, Jose Humberto Tavares Fregnani, Rui Manuel Reis, Ernest T. Hawk and Edmundo Carvalho Mauad
Denise Peixoto Guimarães
1Department of Endoscopy, Molecular Oncology Research Center, Barretos Cancer Hospital
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  • For correspondence: guimaraes.dp@gmail.com
Larissa Andreoli Mantuan
2Molecular Oncology Research Center, Barretos Cancer Hospital
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Marco Antonio de Oliveira
3Nucleous of Epidemiology and Statistics, Barretos Cancer Hospital
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Raphael Luiz Haikel Junior
4Department of Prevention, Barretos Cancer Hospital
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Allini Mafra da Costa
5Cancer Registry, Barretos Cancer Hospital
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  • ORCID record for Allini Mafra da Costa
Silvana Rossi
4Department of Prevention, Barretos Cancer Hospital
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Gilberto Fava
6Department of Endoscopy, Barretos Cancer Hospital
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Leonardo Nogueira Taveira
6Department of Endoscopy, Barretos Cancer Hospital
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Kelly Menezio Giardina
6Department of Endoscopy, Barretos Cancer Hospital
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Thais Talarico
2Molecular Oncology Research Center, Barretos Cancer Hospital
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Maraisa Costa
2Molecular Oncology Research Center, Barretos Cancer Hospital
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Cristovam Scapulatempo-Neto
7Barretos Cancer Hospital
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Marcus M Matsushita
7Barretos Cancer Hospital
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Carlos Augusto Rodrigues Véo
8Cirurgia oncológica, Hospital de Câncer de Barretos
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  • ORCID record for Carlos Augusto Rodrigues Véo
Jose Humberto Tavares Fregnani
2Molecular Oncology Research Center, Barretos Cancer Hospital
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Rui Manuel Reis
2Molecular Oncology Research Center, Barretos Cancer Hospital
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Ernest T. Hawk
9Division of Cancer Prevention and Population Sciences, University of Texas MD Anderson Cancer Center
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Edmundo Carvalho Mauad
10Cancer Prevention Department, Barretos Cancer Hospital
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DOI: 10.1158/1940-6207.CAPR-20-0179
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Abstract

Colorectal cancer (CRC) is the second most common cancer in Brazil. Yet, a nationally organized colorectal screening program is not implemented. Barretos Cancer Hospital (BCH) is one of the largest Brazilian institution, which cares for underserved patients. BCH developed a FIT-based organized CRC screening program to improve CRC outcomes. This study aims to present the quality/performance measures of the first two years of the FIT-based CRC screening program and its impact on the CRC disease stage. Between 2015 and 2017, a total of 6,737 individuals attending the Outpatient Department of Prevention or the Mobile Unit of BCH, which visits 18 cities of Barretos county, aged 50 to 65 years old, were personally invited by a health agent/ nurse practitioner. Exclusion criteria were personal history of CRC, adenomatous polyps, inflammatory bowel disease, and colonoscopy or flexible sigmoidoscopy performed in the past five years. European Union (EU) guidelines for CRC screening programs were evaluated. Overall, 92.8% returned the FIT, with an inadequate examination rate of 1.5%. Among the 6,253 adequately tested, 12.5% had a positive result. The colonoscopy compliance and completion rates were 84.6 and 98.2%, respectively. The PPVs were 60.0%, 16.5%, and 5.6% for adenoma, advanced adenoma and cancer, respectively. Stage distribution of screen-detected cancers shows earlier stages than clinically diagnosed CRC cancers reported at BCH and Brazilian cancer registries. Our CRC screening program achieved desirable quality metrics, aligned with the EU Guidelines. The observed shift towards earlier CRC stages suggests an exciting opportunity to improve CRC-related cancers in Brazil.

  • Received May 1, 2020.
  • Revision received August 1, 2020.
  • Accepted September 22, 2020.
  • Copyright ©2020, American Association for Cancer Research.

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This OnlineFirst version was published on September 30, 2020
doi: 10.1158/1940-6207.CAPR-20-0179

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The performance of colorectal cancer screening in Brazil: the first two years of the implementation program in Barretos Cancer Hospital
Denise Peixoto Guimarães, Larissa Andreoli Mantuan, Marco Antonio de Oliveira, Raphael Luiz Haikel Junior, Allini Mafra da Costa, Silvana Rossi, Gilberto Fava, Leonardo Nogueira Taveira, Kelly Menezio Giardina, Thais Talarico, Maraisa Costa, Cristovam Scapulatempo-Neto, Marcus M Matsushita, Carlos Augusto Rodrigues Véo, Jose Humberto Tavares Fregnani, Rui Manuel Reis, Ernest T. Hawk and Edmundo Carvalho Mauad
Cancer Prev Res September 30 2020 DOI: 10.1158/1940-6207.CAPR-20-0179

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The performance of colorectal cancer screening in Brazil: the first two years of the implementation program in Barretos Cancer Hospital
Denise Peixoto Guimarães, Larissa Andreoli Mantuan, Marco Antonio de Oliveira, Raphael Luiz Haikel Junior, Allini Mafra da Costa, Silvana Rossi, Gilberto Fava, Leonardo Nogueira Taveira, Kelly Menezio Giardina, Thais Talarico, Maraisa Costa, Cristovam Scapulatempo-Neto, Marcus M Matsushita, Carlos Augusto Rodrigues Véo, Jose Humberto Tavares Fregnani, Rui Manuel Reis, Ernest T. Hawk and Edmundo Carvalho Mauad
Cancer Prev Res September 30 2020 DOI: 10.1158/1940-6207.CAPR-20-0179
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