Results of personalised invitations of Czech citizens to cancer screening programmes in 2014
The project of personalised invitations of citizens to cancer screening programmes was launched in the Czech Republic in January 2014. Women are invited to participate in breast cancer screening and cervical cancer screening; men and women are invited to participate in colorectal cancer screening. The project aims to enhance the current cancer prevention programmes, and to increase their participation rates; therefore, personalised invitations are sent to citizens who do not participate in cancer screening programmes in the long term, and thus are at a higher risk of developing cancer.
The project is coordinated by the Czech Ministry of Health in cooperation with representatives of the relevant medical societies (gynaecology, gastroenterology, gastrointestinal oncology, diagnostic radiology, general medicine), representatives of health insurance companies, and other leading experts in the field. All health insurance companies invite their clients (persons insured) to participate in cancer screening programmes, reimbursing all examinations needed. The project is financially supported from the EU funds.
“The Czech Republic ranks among countries with the highest cancer incidence rates worldwide. Each year more than 77,000 people are diagnosed with cancer in the Czech Republic, and there are almost 28,000 cancer deaths,” said Svatopluk Nemecek, Minister of Health of the Czech Republic. “By the end of 2013, the prevalence of cancer patients in the Czech Republic was more than 450,000 people. These alarming statistics clearly prove the need for effective cancer prevention. According to preliminary data, cancer was diagnosed in 602 patients within the screening programme. A vast majority of these findings have a very high chance of successful treatment.”
Since the start of the project, more than 2 million Czech citizens have been invited to attend preventive health checks. Personalised invitations as part of cancer screening programmes were launched in January 2014. The project aims to increase the participation rates in screening programmes, which are focused on the detection of breast cancer and cervical cancer in women, and colorectal cancer in men and women. Invitations are sent to citizens from high-risk age groups who have not undergone these preventive examinations yet. The project has been prepared and coordinated by the Czech Ministry of Health in cooperation with expert medical societies and health care payers (health insurance companies). Health insurance companies themselves send personalised invitations to their clients. Since March 2014, the project of personalised invitations has been supported by a nationwide health education campaign. The total budget of the project is approximately 107 million CZK, out of which 62 million CZK have been assigned to personalised invitations. The project has been financed mostly from the EU funds (85%), and partly from the state budget (15%). A total of 43,796,450 CZK were used in 2014.
The tables and charts below show the results of personalised invitations in the first twelve months of the project. Besides the Czech Ministry of Health, an independent evaluation of the results – based on data from health care payers – is also performed by the Institute of Biostatistics and Analyses of the Masaryk University. Results of this evaluation show that although hundreds of thousands of people have already participated in screening programmes, there is still a large proportion of people who have chosen not to attend these free-of-charge preventive health checks. The Czech Ministry of Health will therefore continue to support cancer prevention, mainly by personalised invitations and health education campaigns.
More information about individual cancer screening programmes is available at www.mamo.cz (breast cancer screening), www.kolorektum.cz (colorectal cancer screening), and www.cervix.cz (cervical cancer screening).
Cancer Screening Programmes in the Czech Republic
 |
 |
 |
Results of personalised invitations in the Czech media
| Press conference of the Czech Ministry of Health | Hyde Park (Czech TV): Cancer prevention |
 |
 |
Results of personalised invitations in numbers
Table 1: Results of cancer screening programmes before the start of personalised invitations, and modelled results after the start of personalised invitations, all age groups.
| Monitored period of organised screening |
Cervical cancer (C53) |
Breast cancer (C50) |
Colorectal cancer (C18–C20) |
| 2010–2013 | 2002–2013 | 2006–2013 | |
| Total number of performed screening examinations |
8,411,969 cytology examinations | 4,863,628 mammography examinations | 3,559,558 FOBT 19,798 PSC |
| Number of patients with a positive result of screening examination* | 19,405 patients with a cytological finding of precancerous lesion or carcinoma | 24,994 patients with a finding of breast cancer | 44,378 patients with a finding of adenoma 5,066 patients with a finding of carcinoma |
| * In the vast majority of these findings, there is a high chance of a complete cure. | |||
| Number of people coming as a result of personalised invitations (2014 – preliminary data) |
55,393 cytology examinations | 70,082 mammography examinations | 217,214 FOBT or PSC |
| Number of patients with a positive result of screening examination as a result of personalised invitations (2014 – preliminary data)* |
105 patients with a cytological finding of precancerous lesion or carcinoma | 332 patients with a finding of breast cancer | 4,170 patients with a finding of adenoma 165 patients with a finding of carcinoma |
| * In the vast majority of these findings, there is a high chance of a complete cure. | |||
Abbreviations: FOBT = faecal occult blood test; PSC = primary screening colonoscopy
Source of data: Institute of Biostatistics and Analyses of the Masaryk University (cancer screening programmes), Czech National Reference Centre, health care payers
Table 2: Numbers of insured persons invited to individual cancer screening programmes during 2014 (invitations sent to a total of 1,959,504* persons).
| Variant of the invitation letter | Invitation to participate in |
||
| cervical cancer screening |
breast cancer screening |
colorectal cancer screening |
|
| Men invited to participate in colorectal cancer screening | 783,151 | ||
| Women invited to participate in cervical cancer screening | 217,484 | ||
| Women invited to participate in breast cancer screening | 126,962 | ||
| Women invited to participate in cervical and breast cancer screening | 114,161 | 114,161 | |
| Women invited to participate in colorectal cancer screening | 391,152 | ||
| Women invited to participate in cervical and colorectal cancer screening | 46,350 | 46,350 | |
| Women invited to participate in breast and colorectal cancer screening | 61,853 | 61,853 | |
| Women invited to participate in all cancer screening programmes | 218,211 | 218,211 | 218,211 |
| Total number of insured persons invited to cancer screening programmes | 596,386 | 521,187 | 1,500,897 |
* The total number of invited persons does not correspond to the sum of numbers of invited persons to individual programmes, because many insured persons are invited to multiple programmes at the same time.
Table 3: Reactions of clients to cancer screening invitations – participation rate of persons invited in the first half of 2014.
| Screening programme |
Participation rate (%) |
| Cervical cancer screening | 9.3 |
| Breast cancer screening | 13.4 |
| Colorectal cancer screening | 14.5 |
Table 4: Basic epidemiological characteristics of colorectal cancer, breast cancer in women, and cervical cancer in the Czech Republic in the period 2007–2011.1
| Parameter | Sex | Colorectal cancer (C18–C20) |
Breast cancer (C50) in women |
Cervical cancer (C53) |
| Incidence rates |
||||
| Number of new cases per 100,000 population per year | Men: Women: |
93.4 61.5 |
– 121.3 |
– 19.0 |
| Absolute number of new cases per year |
Men: |
4,802 3,282 |
– 6,475 |
– 1,016 |
| Proportion in the overall cancer incidence | Men: Women: |
12.1 % 9.3 % |
– 18.3 % |
– 2.9 % |
| Trend in the period 2001–2011 | Men: Women: |
+ 8 % + 2 % |
– + 23 % |
– – 7.5 % |
| Typical age of patients (25th–75th percentile) Occurrence men : women |
Men: Women: |
61–76 years 62–79 years 1.5 : 1 |
– 54–73 years – |
– 40–64 years – |
| Mortality rates2 | ||||
| Number of deaths per 100,000 population per year | Men: Women: |
43.1 29.4 |
– 31.2 |
– 6.0 |
| Absolute number of deaths per year | Men: Women: |
2,122 1,565 |
– 1,725 |
– 315 |
| Trend in the period 2001–2011 | – 16 % | – 14 % | – 17 % | |
| Proportion in the overall cancer mortality | Men: Women: |
4.1 % 3.0 % |
– 3.2 % |
– 0.6 % |
| Prevalence rates |
||||
| Survivors per 100,000 population (as on 31 Dec 2011) |
Men: Women: |
553.5 421.0 |
– 1,257.9 |
– 325.4 |
| Absolute number of survivors (as on 31 Dec 2011) |
Men: Women: |
28,550 22,514 |
– 67,261 |
– 17,398 |
| Trend in the period 2001–2011 | Men: Women: |
+ 66 % + 52 % |
– + 69 % |
– + 25 % |
1 Overall epidemiological burden, data involving all records on respective cancers including their diagnosis as another primary cancer in the same person. Source of Data: Czech National Cancer Registry
2 Source of data: Czech Statistical Office
Incidence = Number of newly diagnosed cancers per one year, expressed either as an absolute number of cases or as a rate per 100,000 persons (men or women).
Mortality = Number of cancer-related deaths per one year, expressed either as an absolute number of cancer-related deaths or as a rate per 100,000 persons (men or women).
Prevalence = Number of people who had received a diagnosis of cancer who were alive on 31 Dec 2011, expressed either as an absolute number of survivors or as a rate per 100,000 persons (men or women).
 Fig. 1: Increase in the number of examinations in the Cervical Cancer Screening Programme |
 Fig. 2: Increase in the number of examinations in the Breast Cancer Screening Programme |
 Fig. 3: Increase in the number of examinations in the Colorectal Cancer Screening Programme |
 Fig. 4: Cervical cancer screening – response to invitations, according to age |
 Fig. 5: Cervical cancer screening – response to invitations, according to region |
 Fig. 6: Breast cancer screening – response to invitations, according to age |
 Fig. 7: Breast cancer screening – response to invitations, according to region |
 Fig. 8: Colorectal cancer screening – response to invitations, according to age |
 Fig. 9: Colorectal cancer screening – response to invitations, according to region |
 Fig. 10: Breast cancer (C50) epidemiology in the Czech Republic |
 Fig. 11: Cervical cancer (C53) epidemiology in the Czech Republic |
 Fig. 12: Colorectal cancer (C18-C20) epidemiology in the Czech Republic (both sexes) |
 Fig. 13: Significant drop in Czech mortality rates for cancers covered with screening programmes |
Keywords: breast cancer screening, cervical cancer screening, colorectal cancer screening, personalised invitations
16. 4. 2015 Czech Ministry of Health, Institute of Biostatistics and Analyses of Masaryk University
