cancers Article National Colorectal Cancer Screening Program in Lithuania: Description of the 5-Year Performance on Population Level Audrius Dulskas 1,2, * , Tomas Poskus 2 , Inga Kildusiene 3 , Ausvydas Patasius 3,4 , Rokas Stulpinas 2,5 , Arvydas Laurinaviˇ cius 2,5 , Laura Mašalait ˙ e 2 , Gabriel ˙ e Milaknyt ˙ e 2 , Ieva Stundien ˙ e 2 , Lina Venceviciene 6,7 , Kestutis Strupas 2 , Narimantas E. Samalavicius 2,8,9 and Giedre Smailyte 3,4   Citation: Dulskas, A.; Poskus, T.; Kildusiene, I.; Patasius, A.; Stulpinas, R.; Laurinaviˇ cius, A.; Mašalait ˙ e, L.; Milaknyt ˙ e, G.; Stundien ˙ e, I.; Venceviciene, L.; et al. National Colorectal Cancer Screening Program in Lithuania: Description of the 5-Year Performance on Population Level. Cancers 2021, 13, 1129. https://doi.org/10.3390/cancers 13051129 Academic Editors: Hidekazu Suzuki and Éric Chastre Received: 26 December 2020 Accepted: 22 February 2021 Published: 6 March 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Laboratory of Clinical Oncology, National Cancer Institute, 1 Santariskiu Str., LT-08406 Vilnius, Lithuania 2 Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. ˇ Ciurlionio Str. 21/27, LT-03101 Vilnius, Lithuania; tomas.poskus@santa.lt (T.P.); rokas.stulpinas@vpc.lt (R.S.); arvydas.laurinavicius@vpc.lt (A.L.); laura.masalaite@santa.lt (L.M.); gabriele.milaknyte@santa.lt (G.M.); ieva.stundiene@santa.lt (I.S.); kestutis.strupas@santa.lt (K.S.); narimantas.samalavicius@gmail.com (N.E.S.) 3 Laboratory of Cancer Epidemiology, National Cancer Institute, LT-08406 Vilnius, Lithuania; inga.kildusiene@nvi.lt (I.K.); ausvydas.patasius@nvi.lt (A.P.); giedre.smailyte@nvi.lt (G.S.) 4 Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania 5 National Centre of Pathology, Affiliate of Vilnius University Hospital Santaros Klinikos, 5 P. Baublio Str., LT-08406 Vilnius, Lithuania 6 Clinic of Internal Medicine, Family Medicine and Oncology, Faculty of Medicine, Vilnius University, LT-08410 Vilnius, Lithuania; lina.venceviciene@santa.lt 7 Centre of Family Medicine, Vilnius University Hospital Santaros Klinikos, LT-08410 Vilnius, Lithuania 8 Department of Surgery, Klaipeda University Hospital, 41 Liepojos Str., 92288 Klaipeda, Lithuania 9 Health Research and Innovation Science Center, Faculty of Health Sciences, Klaipeda University, 84 Herkaus Manto Str., LT-92288 Klaipeda, Lithuania * Correspondence: audrius.dulskas@nvi.lt or audrius.dulskas@gmail.com; Tel.: +370-6752-0094 Simple Summary: The first Lithuanian analysis of colorectal cancer screening program is presented in our manuscript. We found that program is run with minimal expenses and still surpasses minimal requirements proposed by the European Union. Still the coverage is lower being 49.6% and must be improved. Abstract: We aimed to report the results of the implementation of the National Colorectal Cancer (CRC) Screening Program covering all the country. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the program has its own administrative code. Information about services provided within the program was retrieved from the database of NHIF starting from the 1 January 2014 to the 31 December 2018. Exact date and type of all provided services, test results, date and results of biopsy and histopathological examination were extracted together with the vital status at the end of follow-up, date of death and date of emigration when applicable for all men and women born between 1935 and 1968. Results were compared with the guidelines of the European Union for quality assurance in CRC screening and diagnosis. The screening uptake was 49.5% (754,061 patients) during study period. Participation rate varied from 16% to 18.1% per year and was higher among women than among men. Proportion of test-positive and test-negative results was similar during all the study period—8.7% and 91.3% annually. Between 9.2% and 13.5% of test-positive patients received a biopsy of which 52.3–61.8% were positive for colorectal adenoma and 4.6–7.3% for colorectal carcinoma. CRC detection rate among test-positive individuals varied between 0.93% and 1.28%. The colorectal cancer screening program in Lithuania coverage must be improved. A screening database is needed to systematically evaluate the impact and performance of the national CRC screening program and quality assurance within the program. Keywords: colorectal cancer; colorectal cancer screening; national cohort Cancers 2021, 13, 1129. https://doi.org/10.3390/cancers13051129 https://www.mdpi.com/journal/cancers