COLOTEST Brussels

Introduction: Population screening for colorectal cancer is organized: In Flanders by the "Centrum voor Kankeropsporing" (CvKO) since 2013 In Wallonia and Brussels by the Walloon “Centre Communautaire de Référence” (CCRéf) since 2009, based upon a collaboration with GP’s. In Brussels, the Brussels Coordination Center for Cancer Screening (BruPrev) took over the project in October 2018. It is a pilot project based on a partnership with pharmacy.brussels and CCRéf.  Scope of the project: The focus group is the Brussels population aged between 50 and 74. To be effective, a test must be performed every 2 years. The screening test is an iFOB test ( “Colotest”). The Colotests are available in all Brussels pharmacies, which supply them free of charge upon presentation of a personalized invitation letter or a medical prescription. The pharmacist also engages in active sensitization with eligible patients. Partners: The project is a partnership between BruPrev, pharmacy.brussels and CCRéf. GP are also involved and informed. They can refer patients to the pharmacy with a medical prescription to retrieve an iFOB test. BruPrev is in charge of implementing and coordinating the project. CCRéf analyzes the iFOB tests and hosts the database. Implementation: The citizen, belonging to the target group presents himself at the pharmacy and is handed the test, he performs the test at home and sends it to CCRéf accredited laboratory in a provided envelope (biological material, cat.B). CCRéf processes the incoming tests daily and reports the results twice a week to BruPrev via a secured server. Patients receive their result within 9 days of receiving the iFOB at CCRéf. GP are informed via their personal secured medical messaging. In case of positive result, a postal mail is sent as well. Results are also immediately available on the secured Brussels Health Network system (Abrumet). Results: In 2019, 13 781 Colotests were realized. Considering the tests performed in 2018, the coverage of the eligible target group was 11%. The uptake (% Colotets performed vs. number of invitations sent) was 9.5 In 2020, the project's activities were suspended from 14/04 to 19/05. The number of invitations in 2020 was 39.9% lower than in 2019 and the number of tests performed was 11.7% lower than in 2019. The uptake increased however from 9.5% to 13.1%. In 2021, the project was boosted by an information campaign and the number of Colotests realized (23.107) rose to nearly twice the 2019 number. Learnings: Access to Colotest through the pharmacy is satisfactory. Pharmacists indicated that after a sensitization interview it should be possible to immediately proceed with the delivery of a test providing patient eligibility is confirmed."