Impact of faecal occult blood test screening on emergency admissions and short-term outcomes for colorectal cancer

G. Libby (Lead / Corresponding author), D. H. Brewster, R. J. C. Steele

    Research output: Contribution to journalArticlepeer-review

    5 Citations (Scopus)

    Abstract

    Background

    Small studies have examined the effect of faecal occult blood test (FOBT) screening on the proportion of hospital admissions for colorectal cancer (CRC) classed as an emergency. This study aimed to examine this and short-term outcomes in persons invited for screening compared with a control group not invited.
    Methods

    The invited group comprised all individuals invited between 1 April 2000 and 31 July 2007 in the Scottish arm of the UK demonstration pilot of FOBT, and subsequently diagnosed with CRC aged 50–72?years between 1 May 2000 and 31 July 2009. The controls comprised all remaining individuals in Scotland not invited for FOBT but diagnosed with CRC aged 50–72?years in the same period.
    Results

    There were 2981 people diagnosed with CRC in the group invited for screening (58·3 per cent participated) and 9842 in the control group. Multivariable regression adjusted for sex, age, deprivation, co-morbidities, tumour site and Dukes' stage showed no difference between the groups for emergency admissions (odds ratio (OR) 0·89, 95 per cent confidence interval (c.i.) 0·77 to 1·02; P?=?0·084) or length of hospital stay (LOS) (ß coefficient -1·02 (95 per cent c.i. –1·05 to 1·01) days; P?=?0·226). Comparing participants with controls, there were fewer emergency admissions (OR 0·59, 0·49 to 0·71; P?<?0·001) and shorter LOS (ß coefficient -1·06 (-1·10 to -1·02) days; P?=?0·001). Short-term mortality was lower in the screened than the non-screened population (1·1 versus 2·8 per cent; P?=?0·001).
    Conclusion

    People who participated in FOBT screening had fewer emergency admissions and a shorter LOS. Deprivation was associated negatively with participation, but the impact of FOBT participation on emergency admissions was independent of deprivation level. The reduction in LOS has potential to reduce financial costs.
    Original languageEnglish
    Pages (from-to)1607-1615
    Number of pages9
    JournalBritish Journal of Surgery
    Volume101
    Issue number12
    DOIs
    Publication statusPublished - Nov 2014

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