Randomized study of biennial screening with a faecal occult blood test: results after nine screening rounds

Kronborg, O; Jørgensen, Ole Dan; Fenger, Claus; Rasmussen, Morten

doi:10.1080/00365520410003182

Cited by 216 publications

(156 citation statements)

References 7 publications

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“…5,6 The UK pilot study of population-based CRC screening commenced in 2000. 7 Screening was undertaken using a non-rehydrated guaiacbased FOB test offered to 50-69-year-old adults.…”

Section: Introductionmentioning

confidence: 99%

High Yield of Colorectal Neoplasia Detected by Colonoscopy following a Positive Faecal Occult Blood Test in the Nhs Bowel Cancer Screening Programme

Lee

Clifford

Rajasekhar³

et al. 2011

J Med Screen

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Objectives The UK National Health Service Bowel Cancer Screening Programme (BCSP) is based on a strategy of biennial faecal occult blood (FOB) testing. Positive results are classified as ‘abnormal’ or ‘weak positive’ based on the number of positive windows per kit or need for repeat testing. Colonoscopy is offered to both groups. We evaluate the relationship between FOB test positivity and clinical outcome in the BCSP. Setting The South of Tyne and Tees (UK) Bowel Cancer Screening Centres. Methods Data were collected prospectively on all individuals who were offered FOB testing and colonoscopy between February 2007 and February 2009. Univariable and multivariable analyses were performed to investigate the relationship between FOB test positivity and clinical outcome. Results Following FOB testing, 1524 individuals underwent colonoscopy, 1259 (83%) after a ‘weak positive’ and 265 (17%) an ‘abnormal’ result. Cancer was detected in 180 (11.8%) and adenomas in 758 (49.7%). Individuals with an ‘abnormal’ result were more likely to have cancer or be ‘high risk’ for the development of future adenomas (110/265, 41.5%) than those with ‘weak positive’ results, (236/1259, 18.7%, P < 0.0001). Those with Dukes stage B, C or D cancers or cancers proximal to the splenic flexure were more likely to have an ‘abnormal’ result. Conclusions The majority of colonoscopies were performed following ‘weak positive’ FOB results. Those with an ‘abnormal’ result were more likely to be diagnosed with cancer. The high yield of pathology in both the ‘abnormal’ and ‘weak positive’ groups justifies the need for colonoscopy in both.

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“…5,6 The UK pilot study of population-based CRC screening commenced in 2000. 7 Screening was undertaken using a non-rehydrated guaiacbased FOB test offered to 50-69-year-old adults.…”

Section: Introductionmentioning

confidence: 99%

High Yield of Colorectal Neoplasia Detected by Colonoscopy following a Positive Faecal Occult Blood Test in the Nhs Bowel Cancer Screening Programme

Lee

Clifford

Rajasekhar³

et al. 2011

J Med Screen

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“…The NNScreen was 392 to 936 and the NNScope was 10.3. [11][12][13][14] The Funen study 10 showed the CRC mortality dropped from 18% to 11% after five screening rounds, as a result of decreased compliance. Similar findings were echoed in the Tenerife study in Spain.…”

Section: Guaiac Faecal Occult Blood Testingmentioning

confidence: 99%

Alternatives to colonoscopy for population-wide colorectal cancer screening

Leung¹,

Foo²,

Chan³

et al. 2016

Hong Kong Med J

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“…Four randomized controlled trials have investigated the effect of gFOBT screening on CRC mortality, and the results have been presented in nine reports ( [17][18][19][20][21][22][23][24][25]). Three of the trials [17][18][19][20][21][22][23]25] used repetitive, multiple screening rounds with FOBT (either annually or biennially), whereas the Swedish trial only offered two screening rounds (at the start of the trial period) with a 2-year screening interval [24].…”

Section: Efficacy and Effectivenessmentioning

confidence: 99%

“…Three of the trials [17][18][19][20][21][22][23]25] used repetitive, multiple screening rounds with FOBT (either annually or biennially), whereas the Swedish trial only offered two screening rounds (at the start of the trial period) with a 2-year screening interval [24]. Figure 3 shows a meta-analysis of data from the four randomized trials of the effect of repetitive FOBT screening on CRC mortality.…”

Section: Efficacy and Effectivenessmentioning

confidence: 99%

Colorectal cancer screening

Bretthauer

2011

Journal of Internal Medicine

117

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Abstract. Bretthauer M (Oslo University Hospital, Oslo, Norway). Colorectal cancer screening (Review). J Intern Med 2011; 270: 87-98. Colorectal cancer (CRC) is the third most common cause of cancer death worldwide and a major health problem. In this review, the different approaches for CRC screening will be outlined with emphasis on evidence-based medicine. Evidence from randomized trials on the effectiveness of CRC screening is summarized. Several screening tools for CRC are available. They can be categorized according to their mode of action: early detection tools such as the faecal occult blood test (FOBT) and cancer prevention tools such as flexible sigmoidoscopy and colonoscopy. Metaanalyses of randomized trials show that FOBT screening reduces CRC mortality by 16% (risk ratio 0.84; 95% confidence interval (CI) 0.78-0.9) compared with 30% (risk ratio 0.7; 95% CI 0.6-0.81) for flexible sigmoidoscopy screening. FOBT screening is cheap and noninvasive, but results in large numbers of false-positive tests and needs to be repeated frequently. Flexible sigmoidoscopy is more invasive, but is effective for once-only screening. Although colonoscopy screening is used in some countries, no randomized trials have been conducted to estimate its benefit, and therefore, it should not be recommended at the present time. Faecal occult blood test and flexible sigmoidoscopy are the two CRC screening tools that can be recommended as they have been proven to reduce CRC mortality. Colonoscopy has the potential to be superior to FOBT and flexible sigmoidoscopy, but needs to be evaluated in randomized trials before any recommendation can be provided.

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Randomized study of biennial screening with a faecal occult blood test: results after nine screening rounds

Cited by 216 publications

References 7 publications

High Yield of Colorectal Neoplasia Detected by Colonoscopy following a Positive Faecal Occult Blood Test in the Nhs Bowel Cancer Screening Programme

High Yield of Colorectal Neoplasia Detected by Colonoscopy following a Positive Faecal Occult Blood Test in the Nhs Bowel Cancer Screening Programme

Alternatives to colonoscopy for population-wide colorectal cancer screening

Colorectal cancer screening

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