Digital mammography may be more effective than screen-film mammography in contemporary screening practice in mobile units. The data indicate that digital mammography depicts more tumors than does screen-film mammography, especially lesions seen as microcalcifications. The potential association with improved outcome warrants further study.

No abstract

We assessed the correlation between quantitative results of immunological faecal occult blood testing (I-FOBT) and colonic lesions (191 colorectal cancers, 890 adenomas) detected at colonoscopy in 2597 FOBT þ (cutoff 100 ng ml À1 Hb) subjects. At univariate analysis, a higher average faecal Hb content was significantly associated with male gender (P ¼ 0.003), age (P ¼ 0.02), and colonoscopy findings (P ¼ 0.000). Among adenomas, higher faecal Hb content was significantly associated with size (P ¼ 0.0000), presence of severe dysplasia (P ¼ 0.0001), presence of villous component (P ¼ 0.0002), and location in the left colon (P ¼ 0.003). At multivariate analysis adjusting for potential confounders, age (P ¼ 0.03), size (P ¼ 0.0000), and location in the left colon (P ¼ 0.0005) were confirmed as having an independent association with higher faecal Hb content. Immunological FOBT is confirmed to be a specific screening test to detect cancer and adenoma, with a low positivity rate (3.7%) and a high positive predictive value (41.5%). Faecal Hb content is significantly higher for those lesions (cancer and high-risk adenomas) screening is aimed at detecting. British Journal of Cancer (2007)

The quality of colonoscopy was affected by patient-related, endoscopist-related and centre-related characteristics. Policies addressing organisational issues should improve the quality of colonoscopy in our programme and similar programmes.

Reduced preparation increases participation in CTC. Lower attendance and higher DR of CTC as compared with FIT are key factors for the optimization of its role in population screening of CRC.

No abstract

Immunochemical faecal occult blood tests have shown a greater sensitivity than guaiac test in colorectal cancer screening, but optimal number of samples and cutoff have still to be defined. The aim of this multicentric study was to evaluate the performance of immunochemical-based screening strategies according to different positivity thresholds (80, 100, 120 ng ml À1 ) and single vs double sampling (one, at least one, or both positive samples) using 1-day sample with cutoff at 100 ng ml À1 as the reference strategy. A total of 20 596 subjects aged 50 -69 years were enrolled from Italian population-based screening programmes. Positivity rate was 4.5% for reference strategy and 8.0 and 2.0% for the most sensitive and the most specific strategy, respectively. Cancer detection rate of reference strategy was 2.8%, and ranged between 2.1 and 3.4% in other strategies; reference strategy detected 15.6% advanced adenomas (range ¼ 10.0 -22.5%). The number needed to scope to find a cancer or an advanced adenoma was lower than 2 (1.5 -1.7) for the most specific strategies, whereas it was 2.4 -2.7, according to different thresholds, for the most sensitive ones. Different strategies seem to have a greater impact on adenomas rather than on cancer detection rate. The study provides information when deciding screening protocols and to adapt them to local resources.

The low prevalence of SSPs and the lack of association with the FIT round argue against SSP as a suitable target for FIT-based organised programmes. Strict association of SSP-DR with the key colonoscopy quality indicators, namely caecal intubation rate and high ADR further marginalises the need for SSP-specific quality indicators in FIT-based programmes.