Controlled Trial of Faecal Occult Blood Testing in the Detection of Colorectal Cancer

Hardcastle, J. D.; Farrands, P. A.; Balfour, T. W.; Chamberlain, Jocelyn; Amar, S. S.; Sheldon, M. G.

doi:10.1016/s0140-6736(83)90001-6

Cited by 169 publications

(46 citation statements)

References 14 publications

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“…Hardcastle et al (1980) noted that in a general practice population compliance was highest in the age range 50-65 years declining sharply over 75 years of age. There was an overall compliance rate of 45% in their study compared with 27% in the "Frome experience" (Farrands et al, 1981) and 28% in Salford (Million et al, 1982).…”

Section: Fecatestmentioning

confidence: 98%

“…There was an overall compliance rate of 45% in their study compared with 27% in the "Frome experience" (Farrands et al, 1981) and 28% in Salford (Million et al, 1982). If screening programmes are demonstrated to be beneficial in terms of early diagnosis and prevention of colorectal cancer, more research is needed into optimum recruitment procedures (Halper et al, 1980;Hardcastle et al, 1983).…”

Section: Fecatestmentioning

confidence: 99%

“…It is hoped that removal of polyps by snare polypectomy may also reduce the incidence of subsequent cancer in view of the known tendency for such lesions to pass from a benign to a malignant phase (Grinnell & Lane 1958;Morson, 1966). A number of screening programmes have been carried out and early results of two controlled studies Hardcastle et al, 1983) indicate benefit for the screened population in terms of increased diagnosis of localized lesions (Dukes A & B) with corresponding improved prognosis (Bussey, 1963;Gill & Morris, 1978). Problems remaining relate to identification and compliance of the population to be screened, the sensitivity and specificity of the tests involved and the cost/benefit of the programme compared with any disadvantage from physical and psychological injury involved in the investigative programme.…”

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confidence: 99%

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Screening for colorectal cancer in a factory-based population with Fecatest

Lee¹

1983

Br J Cancer

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Summary This report concerns a screening programme for colorectal cancer using Fecatest, a relatively sensitive test for faecal occult blood, in a factory-based population. A total of 2420 workers between 40 and 65 years of age returned kits for testing following suitable dietary restriction. In Factory A, in which screening was offered as part of an annual medical examination, 989 men agreed to participate, a compliance rate of 45%. In Factory B, in which screening was offered in their weekly pay packets, 1431 men participated, a compliance rate of 22%. An overall positivity rate of 5.8% was found, 4.6% in Factory A and 6.6% in Factory B. Five cancers were found, two of the rectum, one at the recto-sigmoid junction, one in the sigmoid colon and one in the transverse colon. Two of these lesions were at Dukes Stage A, one at Stage B and two at Stage C. In addition, 25 adenomatous polyps were found in 17 men. In 13 these were characterized as tubular adenomata and in 4 as tubulovillous adenomata. The mean age at diagnosis in the polyp cases was 52.6 years and in the cancer cases 58.8 years. Increased specificity is obtained by excluding participants below 46 years of age. The detection rate in the 46-65 year range is -1 in 100 for adenomatous polyps and 1 in 300 for cancer in the population screened. This detection rate is higher than most comparable studies using a less sensitive Guaiac test on older populations.

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Section: Fecatestmentioning

confidence: 98%

Section: Fecatestmentioning

confidence: 99%

mentioning

confidence: 99%

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Screening for colorectal cancer in a factory-based population with Fecatest

Lee¹

1983

Br J Cancer

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“…At present, three randomized conrrollcd trials are in p rogress, two in North America ( IH, 19) and one in the Un ited Kingdom (20) . They will examine the effect of screening with the Hcmoccult rest, sigmoidoscopy or both on colonic cancer mortality.…”

Section: D1\'111on Of Gastroenierology Department Ofmentioning

confidence: 99%

Screening and Diagnosis of Colorectal Cancer

Irvine

Hunt

1988

Canadian Journal of Gastroenterology

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Colorectal cancer is the second most common tumour in North American men and women. From present understanding of the pathogenesis and natural history of l?.rge bowel cancer, theoretically at least, the prevalence rate could be significantly decreased with careful application of simple screening measures and appropriately directed diagnostic tests. Until resu lts of randomized controlled trials are al'ailable, it is importan t to recogn ize the pitfalls of mass screening o r of substituting screening for proper investigative procedures. One possible approach co the diagnosis of coloreccal cancer is ou tlined. Ca n J Gastroe nterol 1988;2(3 ):99-106.

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“…The subject compliance rate to 1989 averaged 57.8% for the initial test and 77.0% for the first re-test. Patients with screen-detected and symptomatic-presenting cancers in both groups have been followed up fully (Hardcastle et al, 1983;. The trial will involve five complete screening rounds for all subjects and is thus expected to continue into the late-1990s.…”

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confidence: 99%

Screening and the costs of treating colorectal cancer

Whynes

Walker²,

Chamberlain³

et al. 1993

Br J Cancer

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The objective of this paper is to compare the hospital costs of treating patients with colorectal cancers detected as a result of a faecal occult blood screening programme with those of patients whose cancers present symptomatically (control group). Patient-specific cost estimates are made, using case records and hospital accounts, for 360 patients over 3 years. Mean treatment costs for the group offered screening and for the control group are calculated to be 3,179 pounds and 2,966 pounds respectively, although the difference between these means is insignificant. Low treatment costs in the case of screen-detected cancers are largely accounted for by polypectomy with no subsequent readmission; in the control group case, they tend to be accounted for by early patient death. For the sample as a whole, the costs of treating very early-, and very late-, stage cancer are significantly lower than those of treating cancers in the intermediate stages. On the basis of trial evidence, the introduction of mass screening for colorectal cancer is unlikely to give rise to substantial economies in the costs of treatment.

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Controlled Trial of Faecal Occult Blood Testing in the Detection of Colorectal Cancer

Cited by 169 publications

References 14 publications

Screening for colorectal cancer in a factory-based population with Fecatest

Screening for colorectal cancer in a factory-based population with Fecatest

Screening and Diagnosis of Colorectal Cancer

Screening and the costs of treating colorectal cancer

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