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

TY - JOUR

T1 - Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer

AU - Steele, Robert

AU - McClements, P. L.

AU - Libby, G.

AU - Black, R.

AU - Morton, C.

AU - Birrell, J.

AU - Mowat, N. A. G.

AU - Wilson, J. A.

AU - Kenicer, M.

AU - Carey, F. A.

AU - Fraser, Callum

PY - 2009/4

Y1 - 2009/4

N2 - 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.

AB - 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.

KW - Aged

KW - Colonoscopy

KW - Colorectal Neoplasms

KW - Early Diagnosis

KW - Feasibility Studies

KW - Female

KW - Guaiac

KW - Humans

KW - Male

KW - Mass Screening

KW - Middle Aged

KW - Neoplasm Staging

KW - Occult Blood

KW - Patient Acceptance of Health Care

KW - Pilot Projects

KW - Predictive Value of Tests

KW - Program Evaluation

KW - Reagent Kits, Diagnostic

KW - Scotland

KW - State Medicine

U2 - 10.1136/gut.2008.162883

DO - 10.1136/gut.2008.162883

M3 - Article

C2 - 19036949

SN - 0017-5749

VL - 58

SP - 530

EP - 535

JO - Gut

JF - Gut

IS - 4

ER -