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Colonoscopy Needs for Implementation of a Colorectal Cancer Screening Program in Ukraine

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Abstract

Background

In Ukraine, there is no established colorectal cancer screening program. We aimed to project the number of screening colonoscopies needed for implementation of various CRC screening strategies in Ukraine.

Methods

We modified a previously developed Markov microsimulation model to reflect the natural history of adenoma and CRC progression among average-risk 50–74-year-olds. We simulated colonoscopies needed for the following screening strategies: no screening, fecal occult blood test yearly, FOBT yearly with flexible sigmoidoscopy every 5 years, FS every 5 years, fecal immunohistochemistry test (FIT) yearly, or colonoscopy every 10 years. Assuming 80% screening adherence, we estimated colonoscopies required at 1 and 5 years depending on the implementation rate. In one-way sensitivity analyses, we varied implementation rate, screening adherence, sensitivity, and specificity.

Results

Assuming an 80% screening adherence and complete implementation (100%), besides a no screening strategy, the fewest screening colonoscopies are needed with an FOBT program, requiring on average 6,600 and 26,800 colonoscopies per 100,000 persons at 1 and 5 years post-implementation, respectively. The most screening colonoscopies are required with a colonoscopy program, requiring on average 76,600 and 101,000 colonoscopies per 100,000 persons at 1 and 5 years post-implementation, respectively. In sensitivity analyses, the biggest driver of number of colonoscopies needed was screening adherence.

Conclusions

The number of colonoscopies needed and therefore the potential strain on the healthcare system vary substantially by screening test. These findings can provide valuable information for stakeholders on equipment needs when implementing a national screening program in Ukraine.

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Authors and Affiliations

  1. Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Vanessa M. Welten, Kirsten F. A. A. Dabekaussen & Nelya Melnitchouk

  2. Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Vanessa M. Welten & Nelya Melnitchouk

  3. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Kerollos Nashat Wanis

  4. The University Hospital, Krakow, Poland

    Solomiia Semeniv

  5. Department of Surgery, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine

    Galyna Shabat

  6. Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Kirsten F. A. A. Dabekaussen

  7. Department of Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, USA

    Jennifer S. Davids

  8. National Cancer Institute, Kyiv, Ukraine

    Andriy Beznosenko

  9. NGO ArcUA, Kyiv, Ukraine

    Ulana Suprun

  10. Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Djøra I. Soeteman

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  1. Vanessa M. Welten
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Correspondence to Vanessa M. Welten.

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Welten, V.M., Wanis, K.N., Semeniv, S. et al. Colonoscopy Needs for Implementation of a Colorectal Cancer Screening Program in Ukraine. World J Surg 46, 2476–2486 (2022). https://doi.org/10.1007/s00268-022-06656-0

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