Ten-year changes in colorectal cancer screening in Switzerland: The Swiss Health Interview Survey 2007, 2012 and 2017

Rémi Schneider; Lamprini Syrogiannouli; Sarah Bissig; Tamara Scharf; Jean-Luc Bulliard; Cyril Ducros; Cinzia Del Giovane; Kali Tal; Marcel Zwahlen; Kevin Selby; Reto Auer

doi:10.1016/j.pmedr.2022.101815

Ten-year changes in colorectal cancer screening in Switzerland: The Swiss Health Interview Survey 2007, 2012 and 2017

Prev Med Rep. 2022 May 6:27:101815. doi: 10.1016/j.pmedr.2022.101815. eCollection 2022 Jun.

Authors

Affiliations

¹ Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
² Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
³ Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Abstract

Recent recommendations for colorectal cancer (CRC) screening suggest fecal occult blood test (FOBT) or colonoscopy. Since 2013, mandatory health insurance in Switzerland reimburse CRC screening. We set out to determine if CRC testing rate and type of CRC screening changed in Switzerland from 2007 to 2017 and between the three main language regions. We extracted data on 50-75-year-olds from the Swiss Health Interview Survey (SHIS) 2007, 2012 and 2017 to determine rates of self-reported testing with FOBT within last 2 years and colonoscopy within last 10 years. We estimated prevalence ratio (PR) in multivariate-adjusted logistic regression models and compared rates in German-, French- and Italian-speaking regions, adjusting for sociodemographic, self-rated health and insurance variables. Overall testing rates (FOBT or colonoscopy) increased in all regions from 2007 to 2017 (German-speaking 33.6% to 48.3%; French-speaking 30.8% to 48.8%; Italian-speaking 37.9% to 46.8%), mainly because of an increase in colonoscopy rate for screening reasons (p < 0.001 in all regions). Rates of FOBT testing fell significantly in the German-speaking region (11.9% to 4.4%, p < 0.001), but not in the Italian- (13.9% to 8.5%, p = 0.052) and French-speaking regions (7.6% to 7.4%, p = 0.138). Overall CRC testing rate rose from 33.2% in 2007 to 48.4% in 2017, mainly because of an increase of colonoscopy rate for screening reasons. Coverage remains below the 65% target of European guidelines. Organized screening programs encouraging FOBT screening could contribute to further increasing the CRC testing rate.

Keywords: CHF, Swiss franc; CRC, Colorectal Cancer; Colonoscopy; Colorectal cancer screening; FIT, fecal immunochemical Test; FOBT, Fecal occult blood test; Fecal occult blood test (FOBT); HDHP, High deductible health plan; HMO, Health Maintenance Organisation; LDHP, Low deductible health plan; SFSO, Swiss Federal Statistics Office; SHIS, Swiss Health Interview Survey; Switzerland.