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Long-term effect of faecal occult blood screening on incidence and mortality from colorectal cancer

  • Author Footnotes
    1 First authors, equally contributed.
    Samia Hamza
    Footnotes
    1 First authors, equally contributed.
    Affiliations
    Burgundy Digestive Cancer Registry, INSERM UMR 866, University of Burgundy, Dijon, France

    University Hospital, Dijon, France
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  • Author Footnotes
    1 First authors, equally contributed.
    Vanessa Cottet
    Footnotes
    1 First authors, equally contributed.
    Affiliations
    Burgundy Digestive Cancer Registry, INSERM UMR 866, University of Burgundy, Dijon, France

    University Hospital, Dijon, France
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  • Nassime Touillon
    Affiliations
    Saône et Loire Cancer Screening Coordinating Centre, Charnay-Les-Mâcon, France
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  • Vincent Dancourt
    Affiliations
    Burgundy Digestive Cancer Registry, INSERM UMR 866, University of Burgundy, Dijon, France

    Côte d’Or Cancer Screening Coordinating Centre, Dijon, France
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  • Claire Bonithon-Kopp
    Affiliations
    Burgundy Digestive Cancer Registry, INSERM UMR 866, University of Burgundy, Dijon, France

    University Hospital, Dijon, France

    Clinical Investigation Center-Clinical Epidemiology, INSERM CIC 1432, University Hospital, France
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  • Côme Lepage
    Affiliations
    Burgundy Digestive Cancer Registry, INSERM UMR 866, University of Burgundy, Dijon, France

    University Hospital, Dijon, France
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  • Jean Faivre
    Correspondence
    Corresponding author at: Registre Bourguignon des Cancers Digestifs, Faculté de Médecine, BP 87900, 21079 Dijon Cedex, France. Tel.: +33 3 80 29 50 15; fax: +33 3 80 66 82 51.
    Affiliations
    Burgundy Digestive Cancer Registry, INSERM UMR 866, University of Burgundy, Dijon, France

    University Hospital, Dijon, France
    Search for articles by this author
  • Author Footnotes
    1 First authors, equally contributed.
Published:September 15, 2014DOI:https://doi.org/10.1016/j.dld.2014.08.041

      Abstract

      Background

      Several randomized trials have shown a reduction of colorectal cancer mortality by screening using guaiac-based faecal occult blood tests. However, little is known on the long-term effect of screening at the population level in everyday practice.

      Methods

      Small-sized geographic areas including a total of 91,199 individuals were allocated to either biennal screening using the Hemoccult-II test or no screening. The expected mortality and incidence in the cohort invited to screening was determined using mortality and incidence in the non-screened population.

      Results

      Colorectal cancer mortality was significantly lower in the population invited to screening than in the non-screened population after 11 screening rounds (standardized mortality ratio: 0.87; 0.80–0.94). The standardized mortality ratio remained significant whatever the duration of follow-up. This reduction in colorectal cancer mortality was more pronounced in those who participated in the first screening campaign, who were regular participants in screening rounds (standardized mortality ratio: 0.67; 0.59–0.76). In contrast, colorectal cancer incidence was not different between the screened and non-screened populations (standardized incidence ratio: 1.01; 0.96–1.06).

      Conclusion

      Our findings confirm, in the long term, that screening with Hemoccult can reduce colorectal cancer mortality. The data also highlight the benefit of regular participation in screening and the absence of effect of screening on colorectal cancer incidence.

      Keywords

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