Endoscopy 2012; 44(S 03): SE31-SE48
DOI: 10.1055/s-0032-1309783
Guidelines
© Georg Thieme Verlag KG Stuttgart · New York

European guidelines for quality assurance in colorectal cancer screening and diagnosis. First Edition – Organisation

N. Malila
1   Finnish Cancer Registry, Helsinki, Finland
,
C. Senore
2   CPO Piemonte and S. Giovanni University Hospital, Turin. Italy
,
P. Armaroli
2   CPO Piemonte and S. Giovanni University Hospital, Turin. Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
25 September 2012 (online)

Multidisciplinary, evidence-based guidelines for quality assurance in colorectal cancer screening and diagnosis have been developed by experts in a project coordinated by the International Agency for Research on Cancer. The full guideline document covers the entire process of population-based screening. It consists of 10 chapters and over 250 recommendations, graded according to the strength of the recommendation and the supporting evidence. The 450-page guidelines and the extensive evidence base have been published by the European Commission. The chapter on organisation includes 29 graded recommendations. The content of the chapter is presented here to promote international discussion and collaboration by making the principles and standards recommended in the new EU Guidelines known to a wider professional and scientific community. Following these recommendations has the potential to enhance the control of colorectal cancer through improvement in the quality and effectiveness of the screening process, including multi-disciplinary diagnosis and management of the disease.

 
  • References

  • 1 Aoun E, bdul-Baki H, Azar C et al. A randomized single-blind trial of split-dose PEG-electrolyte solution without dietary restriction compared with whole dose PEG-electrolyte solution with dietary restriction for colonoscopy preparation. Gastrointest Endosc 2005; 62: 213-218
  • 2 Atkin W, Valori R, Kuipers EJ et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Colonoscopic surveillance following adenoma removal. Endoscopy 2012; 44: SE151-SE163
  • 3 Atkin WS, Hart A, Edwards R et al. Single blind, randomised trial of efficacy and acceptability of oral picolax versus self administered phosphate enema in bowel preparation for flexible sigmoidoscopy screening. BMJ 2000; 320: 1504-1508
  • 4 Austoker J, Giordano L, Hewitson P et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Communication. Endoscopy 2012; 44: SE164-SE185
  • 5 Baglietto L, Jenkins MA, Severi G et al. Measures of familial aggregation depend on definition of family history: meta-analysis for colorectal cancer. J Clin Epidemiol 2006; 59: 114-124
  • 6 Bastani R, Yabroff KR, Myers RE et al. Interventions to improve follow-up of abnormal findings in cancer screening. Cancer 2004; 101: 1188-1200
  • 7 Baxter NN, Goldwasser MA, Paszat LF et al. Association of colonoscopy and death from colorectal cancer. Ann.Intern.Med 2009; 150: 1-8
  • 8 Belsey J, Epstein O, Heresbach D. Systematic review: oral bowel preparation for colonoscopy. Aliment Pharmacol Ther 2007; 25: 373-384
  • 9 Benhamiche-Bouvier AM, Lejeune C, Jouve JL et al. Family history and risk of colorectal cancer: implications for screening programmes. J Med Screen 2000; 7: 136-140
  • 10 Benson VS, Patnick J, Davies AK et al. Colorectal cancer screening: a comparison of 35 initiatives in 17 countries. Int J Cancer 2008; 122: 1357-1367
  • 11 Bos AB, van Ballegooijen M, van Gessel-Dabekaussen AA et al. Organised cervical cancer screening still leads to higher coverage than spontaneous screening in The Netherlands. Eur J Cancer 1998; 34: 1598-1601
  • 12 Brawarsky P, Brooks DR, Mucci LA et al. Effect of physician recommendation and patient adherence on rates of colorectal cancer testing. Cancer Detect Prev 2004; 28: 260-268
  • 13 Brenner H, Chang-Claude J, Seiler CM et al. Potential for colorectal cancer prevention of sigmoidoscopy versus colonoscopy: population-based case control study. Cancer Epidemiol Biomarkers Prev 2007; 16: 494-499
  • 14 Brenner H, Hoffmeister M, Arndt V et al. Gender differences in colorectal cancer: implications for age at initiation of screening. Br J Cancer 2007; 96: 828-831
  • 15 Brenner H, Hoffmeister M, Haug U. Should colorectal cancer screening start at the same age in European countries? Contributions from descriptive epidemiology. Br J Cancer 2008; 99: 532-535
  • 16 Brotherstone H, Miles A, Robb KA et al. The impact of illustrations on public understanding of the aim of cancer screening. Patient Educ Couns 2006; 63: 328-335
  • 17 Bucchi L, Serafini M. Spontaneous screening for cervical cancer and diagnostic histories of incident cases. Tumori 1992; 78: 239-243
  • 18 Burnand B, Harris JK, Wietlisbach V et al. Use, appropriateness, and diagnostic yield of screening colonoscopy: an international observational study (EPAGE). Gastrointest Endosc 2006; 63: 1018-1026
  • 19 Butterworth AS, Higgins JP, Pharoah P. Relative and absolute risk of colorectal cancer for individuals with a family history: a meta-analysis. Eur J Cancer 2006; 42: 216-227
  • 20 Chamot E, Charvet AI, Perneger TV. Who gets screened, and where: a comparison of organised and opportunistic mammography screening in Geneva, Switzerland. Eur J Cancer 2007; 43: 576-584
  • 21 Church JM. A scoring system for the strength of a family history of colorectal cancer. Dis Colon Rectum 2005; 48: 889-896
  • 22 Church TR, Yeazel MW, Jones RM et al. A randomized trial of direct mailing of fecal occult blood tests to increase colorectal cancer screening. J Natl Cancer Inst 2004; 96: 770-780
  • 23 Cohen LB. Split dosing of bowel preparations for colonoscopy: an analysis of its efficacy, safety, and tolerability. Gastrointest Endosc 2010; 72: 406-412
  • 24 Cokkinides VE, Chao A, Smith RA et al. Correlates of underutilization of colorectal cancer screening among U.S. adults, age 50 years and older. Prev Med 2003; 36: 85-91
  • 25 Cole SR, Smith A, Wilson C et al. An advance notification letter increases participation in colorectal cancer screening. J Med Screen 2007; 14: 73-75
  • 26 Cole SR, Young GP. Effect of dietary restriction on participation in faecal occult blood test screening for colorectal cancer. Med J Aust 2001; 175: 195-198
  • 27 Cole SR, Young GP, Byrne D et al. Participation in screening for colorectal cancer based on a faecal occult blood test is improved by endorsement by the primary care practitioner. J Med Screen 2002; 9: 147-152
  • 28 Cole SR, Young GP, Esterman A et al. A randomised trial of the impact of new faecal haemoglobin test technologies on population participation in screening for colorectal cancer. J Med Screen 2003; 10: 117-122
  • 29 Costanza ME, Luckmann R, Stoddard AM et al. Using tailored telephone counseling to accelerate the adoption of colorectal cancer screening. Cancer Detect Prev 2007; 31: 191-198
  • 30 Cottet V, Pariente A, Nalet B et al. Colonoscopic screening of first-degree relatives of patients with large adenomas: increased risk of colorectal tumors. Gastroenterology 2007; 133: 1086-1092
  • 31 Council of the European Union. Council Recommendation of 2 December 2003 on cancer screening (2003/878/EC). Off J Eur Union; 2003: 34-38
  • 32 Courtier R, Casamitjana M, Macia F et al. Participation in a colorectal cancer screening programme: influence of the method of contacting the target population. Eur J Cancer Prev 2002; 11: 209-213
  • 33 Dassow P. Setting educational priorities for women's preventive health: measuring beliefs about screening across disease states. J Womens Health (Larchmt.) 2005; 14: 324-330
  • 34 Dove-Edwin I, Sasieni P, Adams J et al. Prevention of colorectal cancer by colonoscopic surveillance in individuals with a family history of colorectal cancer: 16 year, prospective, follow-up study. BMJ 2005; 331: 1047
  • 35 Eddy DM. Screening for colorectal cancer. Ann.Intern.Med 1990; 113: 373-384
  • 36 Eisinger F, Cals L, Calazel-Benque A et al. Impact of organised programs on colorectal cancer screening. BMC.Cancer 2008; 8: 104
  • 37 Engelstad LP, Stewart SL, Nguyen BH et al. Abnormal Pap smear follow-up in a high-risk population. Cancer Epidemiol Biomarkers Prev 2001; 10: 1015-1020
  • 38 Etzioni DA, Yano EM, Rubenstein LV et al. Measuring the quality of colorectal cancer screening: the importance of follow-up. Dis Colon Rectum 2006; 49: 1002-1010
  • 39 Federici A, Giorgi RP, Bartolozzi F et al. The role of GPs in increasing compliance to colorectal cancer screening: a randomised controlled trial (Italy). Cancer Causes Control 2006; 17: 45-52
  • 40 Federici A, Giorgi RP, Borgia P et al. The immunochemical faecal occult blood test leads to higher compliance than the guaiac for colorectal cancer screening programmes: a cluster randomized controlled trial. J Med Screen 2005; 12: 83-88
  • 41 Ferlay J, Shin HR, Bray F et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10. [Internet] Lyon, France: International Agency for Research on Cancer; 2010 Available from: http://globocan.iarc.fr Accessed on 05/04/2012
  • 42 Giorgi Rossi P, Federici A, Bartolozzi F et al. Understanding non-compliance to colorectal cancer screening: a case control study, nested in a randomised trial [ISRCTN83029072]. BMC Public Health 2005; 5: 139
  • 43 Goulard H, Boussac-Zarebska M, Ancelle-Park R et al. French colorectal cancer screening pilot programme: results of the first round. J Med Screen 2008; 15: 143-148
  • 44 Grazzini G, Castiglione G, Isu A et al. Colorectal cancer screening by fecal occult blood testing: results of a population-based experience. Tumori 2000; 86: 384-388
  • 45 Halloran S, Launoy G, Zappa M. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Faecal Occult Blood Testing. Endoscopy 2012; 44: SE65-SE87
  • 46 Harris MA, Byles JE, Cockburn J et al. A general practice-based recruitment strategy for colorectal cancer screening. Aust NZJ Public Health 2000; 24: 441-443
  • 47 Holschneider CH, Felix JC, Satmary W et al. A single-visit cervical carcinoma prevention program offered at an inner city church: A pilot project. Cancer 1999; 86: 2659-2667
  • 48 IARC. IARC Handbooks of Cancer Prevention. Cervix Cancer Screening. Lyon: IARC Press; 2005
  • 49 Jacobson VJ, Szilagyi P. Patient reminder and patient recall systems to improve immunization rates. Cochrane Database Syst Rev 2005; CD003941
  • 50 James AS, Campbell MK, Hudson MA. Perceived barriers and benefits to colon cancer screening among African Americans in North Carolina: how does perception relate to screening behavior?. Cancer Epidemiol Biomarkers Prev 2002; 11: 529-534
  • 51 Jepson R, Clegg A, Forbes C et al. The determinants of screening uptake and interventions for increasing uptake: a systematic review. Health Technol.Assess 2000; 4: i-133
  • 52 Jerant A, Kravitz RL, Rooney M et al. Effects of a tailored interactive multimedia computer program on determinants of colorectal cancer screening: a randomized controlled pilot study in physician offices. Patient Educ Couns 2007; 66: 67-74
  • 53 Johns LE, Houlston RS. A systematic review and meta-analysis of familial colorectal cancer risk. Am J Gastroenterol 2001; 96: 2992-3003
  • 54 King J, Fairbrother G, Thompson C et al. Colorectal cancer screening: optimal compliance with postal faecal occult blood test. Aust NZJ Surg 1992; 62: 714-719
  • 55 Klabunde CN, Schenck AP, Davis WW. Barriers to colorectal cancer screening among Medicare consumers. Am J Prev Med 2006; 30: 313-319
  • 56 Läärä E, Day NE, Hakama M. Trends in mortality from cervical cancer in the Nordic countries: association with organised screening programmes. Lancet 1987; 1: 1247-1249
  • 57 Lakoff J, Paszat LF, Saskin R et al. Risk of developing proximal versus distal colorectal cancer after a negative colonoscopy: a population-based study. Clin Gastroenterol Hepatol 2008; 6: 1117-1121
  • 58 Landsorp-Vogelaar I, von Karsa L. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Introduction. Endoscopy 2012; 44: SE15-SE30
  • 59 Launoy G, Veret JL, Richir B et al. Involvement of general practitioners in mass screening. Experience of a colorectal cancer mass screening programme in the Calvados region (France). Eur J Cancer Prev 1993; 2: 229-232
  • 60 Lawsin C, DuHamel K, Weiss A et al. Colorectal cancer screening among low-income African Americans in East Harlem: a theoretical approach to understanding barriers and promoters to screening. J Urban Health 2007; 84: 32-44
  • 61 Lipkus IM, Green LG, Marcus A. Manipulating perceptions of colorectal cancer threat: implications for screening intentions and behaviors. J Health Commun 2003; 8: 213-228
  • 62 Lynge E, Clausen LB, Guignard R et al. What happens when organization of cervical cancer screening is delayed or stopped?. J Med Screen 2006; 13: 41-46
  • 63 Malila N, Anttila A, Hakama M. Colorectal cancer screening in Finland: details of the national screening programme implemented in Autumn 2004. J Med Screen 2005; 12: 28-32
  • 64 Malila N, Oivanen T, Hakama M. Implementation of colorectal cancer screening in Finland: experiences from the first three years of a public health programme. Z Gastroenterol 2008; 46 (Suppl. 01) 25-28
  • 65 McCaffery K, Wardle J, Nadel M et al. Socioeconomic variation in participation in colorectal cancer screening. J Med Screen 2002; 9: 104-108
  • 66 Menges M, Fischinger J, Gartner B et al. Screening colonoscopy in 40- to 50-year-old first-degree relatives of patients with colorectal cancer is efficient: a controlled multicentre study. Int J Colorectal Dis 2006; 21: 301-307
  • 67 Menon U, Champion VL, Larkin GN et al. Beliefs associated with fecal occult blood test and colonoscopy use at a worksite colon cancer screening program. J Occup Environ Med 2003; 45: 891-898
  • 68 Miles A, Cockburn J, Smith RA et al. A perspective from countries using organized screening programs. Cancer 2004; 101: 1201-1213
  • 69 Miller MF, Wong JG. Reducing financial barriers enhances the return rate of stool Hemoccult packets. Am J Med Sci 1993; 306: 98-100
  • 70 Minozzi S, Armaroli P, Banzi R et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis - First edition. Appendix 1: Systematic evidence review. 2010 http://bookshop.europa.eu/en/european-guidelines-for-quality-assurance-in-colorectal-cancer-screening-and-diagnosis-pbND3210390/ Accessed 12/3/2012
  • 71 Minozzi S, Armaroli P, Segnan N. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Principles of evidence assessment and methods for reaching recommendations. Endoscopy 2012; 44: SE9-SE14
  • 72 Montano DE, Selby JV, Somkin CP et al. Acceptance of flexible sigmoidoscopy screening for colorectal cancer. Cancer Detect Prev 2004; 28: 43-51
  • 73 Moss S, Ancelle-Park R, Brenner H. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Evaluation and interpretation of screening outcomes. Endoscopy 2012; 44: SE49-SE64
  • 74 Nakama H, Zhang B, Fukazawa K et al. Family history of colorectal adenomatous polyps as a risk factor for colorectal cancer. Eur J Cancer 2000; 36: 2111-2114
  • 75 Ness RM, Holmes AM, Klein R et al. Cost-utility of one-time colonoscopic screening for colorectal cancer at various ages. Am J Gastroenterol 2000; 95: 1800-1811
  • 76 Newcomb PA, Storer BE, Morimoto LM et al. Long-term efficacy of sigmoidoscopy in the reduction of colorectal cancer incidence. J Natl Cancer Inst 2003; 95: 622-625
  • 77 Nieminen P, Kallio M, Anttila A et al. Organised vs. spontaneous Pap-smear screening for cervical cancer: A case-control study. Int J Cancer 1999; 83: 55-58
  • 78 Nygard JF, Skare GB, Thoresen SO. The cervical cancer screening programme in Norway, 1992-2000: changes in Pap smear coverage and incidence of cervical cancer. J Med Screen 2002; 9: 86-91
  • 79 Parra-Blanco A, Nicolas-Perez D, Gimeno-Garcia A et al. The timing of bowel preparation before colonoscopy determines the quality of cleansing, and is a significant factor contributing to the detection of flat lesions: a randomized study. World J Gastroenterol 2006; 12: 6161-6166
  • 80 Pignone M, Campbell MK, Carr C et al. Meta-analysis of dietary restriction during fecal occult blood testing. Eff.Clin.Pract 2001; 4: 150-156
  • 81 Pignone M, Saha S, Hoerger T et al. Cost-effectiveness analyses of colorectal cancer screening: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2002; 137: 96-104
  • 82 Plaskon PP, Fadden MJ. Cancer screening utilization: is there a role for social work in cancer prevention?. Soc Work Health Care 1995; 21: 59-70
  • 83 Puliti D, Miccinesi G, Collina N et al. Effectiveness of service screening: a case-control study to assess breast cancer mortality reduction. Br J Cancer 2008; 99: 423-427
  • 84 Quinn M, Babb P, Jones J et al. Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics. BMJ 1999; 318: 904-908
  • 85 Quirke P, Risio M, Lambert R et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Quality assurance in pathology in colorectal cancer screening and diagnosis. Endoscopy 2012; 44: SE116-SE130
  • 86 Regula J, Rupinski M, Kraszewska E et al. Colonoscopy in colorectal-cancer screening for detection of advanced neoplasia. N Engl J Med 2006; 355: 1863-1872
  • 87 Robb KA, Miles A, Campbell J et al. Can cancer risk information raise awareness without increasing anxiety?. A randomized trial. Prev Med 2006; 43: 187-190
  • 88 Ronco G, Pilutti S, Patriarca S et al. Impact of the introduction of organised screening for cervical cancer in Turin, Italy: cancer incidence by screening history 1992-98. Br J Cancer 2005; 93: 376-378
  • 89 Ronco G, Segnan N, Giordano L et al. Interaction of spontaneous and organised screening for cervical cancer in Turin, Italy. Eur J Cancer 1997; 33: 1262-1267
  • 90 Rostom A, Jolicoeur E, Dube C et al. A randomized prospective trial comparing different regimens of oral sodium phosphate and polyethylene glycol-based lavage solution in the preparation of patients for colonoscopy. Gastrointest Endosc 2006; 64: 544-552
  • 91 Saito H, Soma Y, Koeda J et al. Reduction in risk of mortality from colorectal cancer by fecal occult blood screening with immunochemical hemagglutination test. A case-control study. Int J Cancer 1995; 61: 465-469
  • 92 Schenck AP, Klabunde CN, Davis WW. Racial differences in colorectal cancer test use by Medicare consumers. Am J Prev Med 2006; 30: 320-326
  • 93 Seeff LC, Manninen DL, Dong FB et al. Is there endoscopic capacity to provide colorectal cancer screening to the unscreened population in the United States?. Gastroenterology 2004; 127: 1661-1669
  • 94 Segnan N, Patnick J, von Karsa L (eds.) European guidelines for quality assurance in colorectal cancer screening and diagnosis - First edition. Luxembourg: European Commission, Publications Office of the European Union; 2010
  • 95 Segnan N, Senore C, Andreoni B et al. Randomized trial of different screening strategies for colorectal cancer: patient response and detection rates. J Natl Cancer Inst 2005; 97: 347-357
  • 96 Segnan N, Senore C, Andreoni B et al. Comparing attendance and detection rate of colonoscopy with sigmoidoscopy and FIT for colorectal cancer screening. Gastroenterology 2007; 132: 2304-2312
  • 97 Seifert B, Zavoral M, Fric P et al. The role of primary care in colorectal cancer screening: experience from Czech Republic. Neoplasma 2008; 55: 74-80
  • 98 Selby JV, Friedman GD, Quesenberry Jr CP et al. A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 1992; 326: 653-657
  • 99 Senore C, Segnan N, Rossini FP et al. Screening for colorectal cancer by once only sigmoidoscopy: a feasibility study in Turin, Italy. J Med Screen 1996; 3: 72-78
  • 100 Sewitch MJ, Fournier C, Ciampi A et al. Adherence to colorectal cancer screening guidelines in Canada. BMC Gastroenterol 2007; 7: 39
  • 101 Slattery ML, Kinney AY, Levin TR. Factors associated with colorectal cancer screening in a population-based study: the impact of gender, health care source, and time. Prev.Med 2004; 38: 276-283
  • 102 Sondergaard JO, Bulow S, Lynge E. Cancer incidence among parents of patients with colorectal cancer. Int J Cancer 1991; 47: 202-206
  • 103 Steele RJC, Pox C, Kuipers EJ et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Managment of lesions detected in colorectal cancer screening. Endoscopy 2012; 44: SE140-SE150
  • 104 Steele RJC, Rey J-F, Lambert R. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Professional requirements and training. Endoscopy 2012; 44: SE106-SE115
  • 105 Stern MA, Fendrick AM, McDonnell WM et al. A randomized, controlled trial to assess a novel colorectal cancer screening strategy: the conversion strategy – a comparison of sequential sigmoidoscopy and colonoscopy with immediate conversion from sigmoidoscopy to colonoscopy in patients with an abnormal screening sigmoidoscopy. Am J Gastroenterol 2000; 95: 2074-2079
  • 106 Stone EG, Morton SC, Hulscher ME et al. Interventions that increase use of adult immunization and cancer screening services: a meta-analysis. Ann Intern Med 2002; 136: 641-651
  • 107 Sutton S, Wardle J, Taylor T et al. Predictors of attendance in the United Kingdom flexible sigmoidoscopy screening trial. J Med Screen 2000; 7: 99-104
  • 108 Tazi MA, Faivre J, Dassonville F et al. Participation in faecal occult blood screening for colorectal cancer in a well defined French population: results of five screening rounds from 1988 to 1996. J Med Screen 1997; 4: 147-151
  • 109 Tifratene K, Eisinger F, Rinaldi Y et al. Colorectal cancer screening program: cost effectiveness of systematic recall letters. Gastroenterol Clin Biol 2007; 31: 929-933
  • 110 Tu SP, Taylor V, Yasui Y et al. Promoting culturally appropriate colorectal cancer screening through a health educator: a randomized controlled trial. Cancer 2006; 107: 959-966
  • 111 UK Colorectal Cancer Screening Pilot Group. Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom. BMJ 2004; 329: 133
  • 112 Valori R, Rey J-F, Atkin W et al. European guidelines for quality assurance in colorectal cancer screening and diagnosis. First edition. Quality assurance in endoscopy in colorectal screening and diagnosis. Endoscopy 2012; 44: SE88-SE105
  • 113 van Rossum LG, van Rijn AF, Laheij RJ et al. Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population. Gastroenterology 2008; 135: 82-90
  • 114 Vernon SW. Participation in colorectal cancer screening: a review. J Natl Cancer Inst 1997; 89: 1406-1422
  • 115 Vijan S, Inadomi J, Hayward RA et al. Projections of demand and capacity for colonoscopy related to increasing rates of colorectal cancer screening in the United States. Aliment Pharmacol Ther 2004; 20: 507-515
  • 116 von Karsa L, Anttila A, Ronco G et al. Cancer Screening in the European Union. Report on the implementation of the Council Recommendation on Cancer Screening – First Report. Luxembourg: European Commission; 2008 http://ec.europa.eu/health/archive/ph_determinants/genetics/documents/cancer_screening.pdf Accessed 11/2/2012
  • 117 von Karsa L, Lignini TA, Patnick J et al. The dimensions of the CRC problem. Best Pract Res Clin Gastroenterol 2010; 24: 381-396
  • 118 Walsh JM, Salazar R, Terdiman JP et al. Promoting use of colorectal cancer screening tests. Can we change physician behavior?. J Gen Intern Med 2005; 20: 1097-1101
  • 119 Wardle J, McCaffery K, Nadel M et al. Socioeconomic differences in cancer screening participation: comparing cognitive and psychosocial explanations. Soc Sci Med 2004; 59: 249-261
  • 120 Wardle J, Miles A, Atkin W. Gender differences in utilization of colorectal cancer screening. J Med Screen 2005; 12: 20-27
  • 121 Wee CC, McCarthy EP, Phillips RS. Factors associated with colon cancer screening: the role of patient factors and physician counseling. Prev Med 2005; 41: 23-29
  • 122 Weinberg DS, Turner BJ, Wang H et al. A survey of women regarding factors affecting colorectal cancer screening compliance. Prev.Med 2004; 38: 669-675
  • 123 Whitlock EP, Lin JS, Liles E et al. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2008; 149: 638-658
  • 124 Wilson JM, Jungner YG. Principles and practice of mass screening for disease. World Health Organization; 1968 http://whqlibdoc.who.int/php/WHO_PHP_34.pdf Accessed 11/2/2012
  • 125 Woodrow C, Rozmovits L, Hewitson P et al. Bowel cancer screening in England: a qualitative study of GPs' attitudes and information needs. BMC Fam Pract 2006; 7: 53
  • 126 Yabroff KR, Washington KS, Leader A et al. Is the promise of cancer-screening programs being compromised? Quality of follow-up care after abnormal screening results.. Med Care Res Rev 2003; 60: 294-331
  • 127 Zappa M, Castiglione G, Paci E et al. Measuring interval cancers in population-based screening using different assays of fecal occult blood testing: the District of Florence experience. Int J Cancer 2001; 92: 151-154
  • 128 Zauber AG, Lansdorp-Vogelaar I, Knudsen AB et al. Evaluating test strategies for colorectal cancer screening: a decision analysis for the U.S. Preventive Services Task Force. Ann Intern Med 2008; 149: 659-669
  • 129 Zorzi M, de' Bianchi PS, Grazzini G et al. [Ouality indicators for the evaluation of colorectal cancer screening programmes]. Epidemiol Prev 2007; 31: 6-56