1. ESTIMATING THE EFFICIENCY OF THREE NATIONAL CANCER SCREENING PROGRAMMES USING THE POPULATION-BASED CANCER REGISTRY DATA IN SLOVENIA
Vesna ZADNIK MD, PhD
Slovenian Cancer Registry
Institute of Oncology Ljubljana
ww.slora.si/en

2. BACKGROUND: SLOVENIA
SLOVENIA
App: 20,000 km2
2 million inhabitants

3. BACKGROUND: SLOVENIAN CANCER REGISTY
General cancer registry
Population-based
Compulsory notification since 1950
PIN
Follow-up through Central Population Registry
Linkage to screening registries database

4. BACKGROUND: CERVICAL CANCER SCREENING
ZORA
started 2003
conventional cytology
3 years interval
age 20–64
participation 72%

5. BACKGROUND: COLORECTAL CANCER SCREENING
SVIT
started 2009
immunochemical fecal occult blood test, follow up colonoscopy
2 years interval
age 50–74
participation 62%

6. BACKGROUND: BREAST CANCER SCREENING
DORA
started 2008 in central region, countrywide in 2018
digital mammography
2 years interval
age 50–69
participation 73%

7. METHODS SCR data: C53, C18-C20, C50
INCIDENCE TREND: APC (before/after screening)
SCR data linked to screening registries: ATTENDANCE
analysis of screened age groups
NET SURVIVAL (screend/non-screened)
RISK OF DYING (screend/non-screened)
STAGE DISTRIBUTION (screend/non-screened)
Incidence for CerC and CRC for all pts diagnosed in Slovenia from SP start.
Stage distribution, net survival and hazard ratio (HR) of death for screen vs not screen detected cancers diagnosed with CerC, CRC and BC from for all invited patients to the SPs

8. RESULTS: CERVICAL CANCER SCREENING
incidence trend
ZORA
Fifteen years after ZORA started, the incidence of cervical cancer has decreased for more than 50%

9. RESULTS: CERVICAL CANCER SCREENING net survival ZORA
5-yeat net survival:
SCREENED / NON-SCREENED
92.1% / 63.7%
HR:
SCREENED / NON-SCREENED
0.18 (0.11 – 0.28)

10. RESULTS: CERVICAL CANCER SCREENING
stage distribution
ZORA

11. RESULTS: COLORECTAL CANCER SCREENING incidence trend SVIT
APC-males:
: + 7.6%
: - 5.2%
APC-females:
: + 3.9%
: - 4.5%

12. RESULTS: COLORECTAL CANCER SCREENING net survival SVIT
5-yeat net survival:
SCREENED / NON-SCREENED
88.4% / 57.1%
HR:
SCREENED / NON-SCREENED
0.26 ( )

13. RESULTS: COLORECTAL CANCER SCREENING
stage distribution
SVIT

14. BACKGROUND: BREAST CANCER SCREENING net survival DORA
5-yeat net survival:
SCREENED / NON-SCREENED
100% / 89%
HR:
SCREENED / NON-SCREENED
HR 0.17 ( ).

15. BACKGROUND: BREAST CANCER SCREENING
stage distribution
DORA

16. CONCLUSIONS
Slovenian population-based cancer registry database is adequate for estimating the efficiency of three national cancer screening programmes.
Soon after the introduction of organised cancer screenings in Slovenia the two basic cancer burden indicators incidence and survival have improved dramatically. Pts with screen detected cancers are diagnosed in earlier stages and have lower probability to die from cancer.
The two presented and many other cancer burden indicators reported by the PBCRs are (also in Slovenia) most important for planning and evaluation of national cancer screening programmes.