Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer

Robert Steele, P. L. McClements, G. Libby, R. Black, C. Morton, J. Birrell, N. A. G. Mowat, J. A. Wilson, M. Kenicer, F. A. Carey, Callum Fraser

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    Abstract

    Objectives: To assess the effects of the first three rounds of a pilot colorectal screening programme based on guaiac faecal occult blood testing (gFOBT) and their implications for a national population-based programme.

    Methods: A demonstration pilot programme was conducted in three Scottish NHS Boards. Residents aged between 50 and 69 years registered on the Community Health Index were included in the study.

    Results: In the first round, the uptake was 55.0%, the positivity rate was 2.07% and the cancer detection rate was 2.1/1000 screened. In the second round, these were 53.0%, 1.90% and 1.2/1000, respectively, and in the third round, 55.3%, 1.16% and 0.7/1000, respectively. In the first round, the positive predictive value of the gFOBT was 12.0% for cancer and 36.5% for adenoma; these fell to 7.0% and 30.3% in the second round and were maintained at 7.5% and 29.1% in the third round. The percentage of screen-detected cancers diagnosed at Dukes' stage A was 49.2% in the first round, 40.1% in the second round and 36.3% in the third round.

    Conclusions: These results are compatible with those of previous randomised trials done in research settings, demonstrating that population-based colorectal cancer screening is feasible in Scotland and should lead to a comparable reduction in disease-specific mortality.

    Original languageEnglish
    Pages (from-to)530-535
    Number of pages6
    JournalGut
    Volume58
    Issue number4
    DOIs
    Publication statusPublished - Apr 2009

    Keywords

    • Aged
    • Colonoscopy
    • Colorectal Neoplasms
    • Early Diagnosis
    • Feasibility Studies
    • Female
    • Guaiac
    • Humans
    • Male
    • Mass Screening
    • Middle Aged
    • Neoplasm Staging
    • Occult Blood
    • Patient Acceptance of Health Care
    • Pilot Projects
    • Predictive Value of Tests
    • Program Evaluation
    • Reagent Kits, Diagnostic
    • Scotland
    • State Medicine

    Cite this

    Steele, R., McClements, P. L., Libby, G., Black, R., Morton, C., Birrell, J., Mowat, N. A. G., Wilson, J. A., Kenicer, M., Carey, F. A., & Fraser, C. (2009). Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer. Gut, 58(4), 530-535. https://doi.org/10.1136/gut.2008.162883