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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Digestive and Liver DiseaseAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Randomised controlled trial of faecal-occult-blood screening for colorectal cancer.Lancet. 1996; 348: 1472-1477
- Randomised study of screening for colorectal cancer with faecal-occult-blood test.Lancet. 1996; 348: 1467-1471
- Reduction in colorectal cancer mortality by fecal occult blood screening in a French controlled study.Gastroenterology. 2004; 126: 1674-1680
- Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study.New England Journal of Medicine. 1993; 328: 1365-1371
- Union OJotE Council recommendation of 2 December 2003 on cancer screening. 2003 (2003/2878/EC, L2327/2034-2038)
- The impact of population-based faecal occult blood test screening on colorectal cancer mortality: a matched cohort study.British Journal of Cancer. 2012; 107: 255-259
- Randomized study of biennial screening with a faecal occult blood test: results after nine screening rounds.Scandinavian Journal of Gastroenterology. 2004; 39: 846-851
- Nottingham trial of faecal occult blood testing for colorectal cancer: a 20-year follow-up.Gut. 2012; 61: 1036-1040
- The effect of fecal occult-blood screening on the incidence of colorectal cancer.New England Journal of Medicine. 2000; 343: 1603-1607
- Participation in faecal occult blood screening for colorectal cancer in a well defined French population: results of five screening rounds from 1988 to 1996.Journal of Medical Screening. 1997; 4: 147-151
- TNM classification of malignant tumors, fifth edition (1997). Union Internationale Contre le Cancer and the American Joint Committee on Cancer.Cancer. 1997; 80: 1803-1804
- Long-term mortality after screening for colorectal cancer.New England Journal of Medicine. 2013; 369: 1106-1114
- Comparison between a guaiac and three immunochemical faecal occult blood tests in screening for colorectal cancer.European Journal of Cancer. 2012; 48: 2969-2976
- Comparison of a guaiac based and an immunochemical faecal occult blood test in screening for colorectal cancer in a general average risk population.Gut. 2007; 56: 210-214
- Screening for colorectal cancer: randomised trial comparing guaiac-based and immunochemical faecal occult blood testing and flexible sigmoidoscopy.Gut. 2010; 59: 62-68
- Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population.Gastroenterology. 2008; 135: 82-90
- The impact of immunochemical faecal occult blood testing on colorectal cancer incidence.Digestive and Liver Disease. 2014; 46: 82-86
Article info
Publication history
Published online: September 15, 2014
Accepted:
August 22,
2014
Received:
May 15,
2014
Identification
Copyright
© 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc. All rights reserved.