Colonoscopy requirements of population screening for colorectal cancer in New Zealand

Green, Terri, Richardson, Ann, & Parry, Susan (2012) Colonoscopy requirements of population screening for colorectal cancer in New Zealand. New Zealand Medical Journal, 125(1356), pp. 85-95.

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Aim: To estimate the colonoscopy burden of introducing population screening for colorectal cancer in New Zealand.

Methods: Screening for colorectal cancer using biennial immunochemical faecal occult blood tests offered to people aged 50-74 years of age was modelled using population estimates from Statistics New Zealand for 2011-2031. Modelling to determine colonoscopy requirements was based on participation and test positivity rates from published results of screening programmes. Estimates of the number of procedures required for ongoing adenoma surveillance were calculated using screening literature results of adenoma yield, and New Zealand Guidelines for Adenoma Surveillance. Sensitivity analysis was undertaken on key parameters.

Results: For a test positivity of 6.4%, biennial screening using immunochemical faecal occult blood testing with a 60% participation rate, would require 18,000 colonoscopies nationally, increasing to 28,000 by 2031. The majority of procedures are direct referrals from a positive FOBT, with surveillance colonoscopy numbers building over time.

Conclusion: Colonoscopy requirements for immunochemical faecal occult blood based population screening for colorectal cancer are high. Significant expansion of services is required and careful management of surveillance procedures to ensure timely delivery of initial colonoscopies whilst maintaining symptomatic services. A model re-run informed by data from the screening pilot will allow improved estimates for the New Zealand setting.

Impact and interest:

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ID Code: 85052
Item Type: Journal Article
Refereed: Yes
Keywords: adult, occult blood test, New Zealand, Male, major clinical study, aged, article, cancer diagnosis, cancer screening, colonoscopy, colorectal cancer, diagnostic accuracy, feces analysis, female, health program, health survey, human, immunohistochemistry
ISSN: 1175-8716
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Nursing not elsewhere classified (111099)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Deposited On: 30 Jun 2015 23:16
Last Modified: 03 Jul 2015 04:23

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