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Practice Guideline
. 2023 Sep;135(17-18):447-455.
doi: 10.1007/s00508-023-02209-0. Epub 2023 May 31.

Screening for colorectal cancer : A recommendation statement of the Austrian National Committee for Cancer Screening

Gerald Gartlehner  1   2 , Eva Schernhammer  3 , Sigurd F Lax  4   5 , Matthias Preusser  6 , Herbert Bachler  7 , Harald Titzer  8 , Maria Kletecka-Pulker  9 , Helga Turnher  10 , Uwe Siebert  11   12   13
Affiliations
Practice Guideline

Screening for colorectal cancer : A recommendation statement of the Austrian National Committee for Cancer Screening

Gerald Gartlehner et al. Wien Klin Wochenschr. 2023 Sep.

Erratum in

  • Correction to: Screening for colorectal cancer.
    Gartlehner G, Schernhammer E, Lax SF, Preusser M, Bachler H, Titzer H, Kletecka-Pulker M, Turnher H, Siebert U. Gartlehner G, et al. Wien Klin Wochenschr. 2023 Sep;135(17-18):456. doi: 10.1007/s00508-023-02251-y. Wien Klin Wochenschr. 2023. PMID: 37530999 Free PMC article. No abstract available.

Abstract

Background: Colorectal cancer is the fourth most common cancer in Austria. To date, colorectal cancer screening in Austria remains opportunistic and includes colonoscopy or stool-based blood tests. The Austrian National Committee for Cancer Screening developed evidence-based recommendations for a nationwide organized colorectal cancer screening program.

Methods: The methodological framework followed the approach of the United States Preventive Services Task Force. The evidence base underlying the newly developed recommendations comprised a review of the existing published evidence and a decision analytic model tailored to the Austrian context. Using a structured process, committee members considered 1) the magnitude of the net benefit of each screening strategy, 2) the certainty of evidence, and 3) the level of acceptance of the interventions among the target population.

Recommendations: The Austrian National Committee for Cancer Screening recommends the implementation of a nationwide organized colorectal cancer screening program for all adults aged 45-75 years. For persons 65 years or older, screening decisions should occur on an individual basis in accordance with a person's overall health, prior screening history, and preferences. Specifically, the committee recommends either a 10-year screening colonoscopy or biennial fecal immunochemical tests with colonoscopy following a positive result, with both screening strategies considered equivalent. Each citizen should be able to make an informed decision about their preferred screening method. Switching between the two screening strategies should be possible. Following an unremarkable colonoscopy, screening by fecal immunochemical test (FIT) is only required after 10 years. Screening recommendations apply only to asymptomatic persons at average risk for colorectal cancer. The screening program must be pilot tested, and accompanied by a public information campaign, formative evaluation, quality assurance, and data collection.

Keywords: Austria; Colonoscopy; Fecal occult blood test; Guideline; Nationwide; Prevention.

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Conflict of interest statement

G. Gartlehner, E. Schernhammer, S.F. Lax, H. Bachler, H. Titzer, M. Kletecka-Pulker and H. Turnher declare that they have no competing interests. M. Preusser has received honoraria for lectures, consultation, or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Journals, MedMedia, Astra Zeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo, Sanofi, Merck Sharp & Dome, Tocagen, Adastra, Gan & Lee Pharmaceuticals, Servier. U. Siebert declares that he is a member of the Oncology Advisory Council of the Austrian Federal Ministry of Social Affairs, Health, Care and Consumer Protection, a member of the European Commission Initiative on Colorectal Cancer (ECICC) Expert Pool, and Co-Chair of the international SMDM Modeling Good Research Practices Task Force.

Figures

Fig. 1
Fig. 1
Analytic framework for colorectal cancer screening. FIT fecal immunochemical test, gFOBT guaiac fecal occult blood test, SSL sessile serrated lesion
See this image and copyright information in PMC

References

    1. Statistik Austria. Krebserkrankungen. https://www.statistik.at/statistiken/bevoelkerung-und-soziales/gesundhei.... Accessed 6 Feb 2023.
    1. Statistik Austria. Krebserkrankungen in Österreich. https://www.statistik.at/fileadmin/publications/Krebserkrankungen_2022.pdf. Accessed 6 Feb 2023.
    1. Winkels RM, Botma A, Van Duijnhoven FJ, Nagengast FM, Kleibeuker JH, Vasen HF, et al. Smoking increases the risk for colorectal adenomas in patients with Lynch syndrome. Gastroenterology. 2012;142(2):241–247. doi: 10.1053/j.gastro.2011.10.033. - DOI - PubMed
    1. Österreichische Gesellschaft für Gastroenterologie und Hepatologie. Leitlinie Qualitätsgesicherte Vorsorgekoloskopie. http://www.oeggh.at/fachwissen/leitlinien/darm.html. Accessed 6 Feb 2023.
    1. Institute of Medicine . Clinical practice guidelines we Can trust. Washington, DC: The National Academies Press; 2011.

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