The impact of population-based faecal occult blood test screening on colorectal cancer mortality: a matched cohort study

G. Libby (Lead / Corresponding author), D. H. Brewster, P. L. McClements, F. A. Carey, R. J. Black, J. Birrell, C. G. Fraser, R. J. C. Steele (Lead / Corresponding author)

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    Abstract

    Background:Randomised trials show reduced colorectal cancer (CRC) mortality with faecal occult blood testing (FOBT). This outcome is now examined in a routine, population-based, screening programme.Methods:Three biennial rounds of the UK CRC screening pilot were completed in Scotland (2000-2007) before the roll out of a national programme. All residents (50-69 years) in the three pilot Health Boards were invited for screening. They received a FOBT test by post to complete at home and return for analysis. Positive tests were followed up with colonoscopy. Controls, selected from non-pilot Health Boards, were matched by age, gender, and deprivation and assigned the invitation date of matched invitee. Follow-up was from invitation date to 31 December 2009 or date of death if earlier.Results:There were 379?655 people in each group (median age 55.6 years, 51.6% male). Participation was 60.6%. There were 961 (0.25%) CRC deaths in invitees, 1056 (0.28%) in controls, rate ratio (RR) 0.90 (95% confidence interval (CI) 0.83-0.99) overall and 0.73 (95% CI 0.65-0.82) for participants. Non-participants had increased CRC mortality compared with controls, RR 1.21 (95% CI 1.06-1.38).Conclusion:There was a 10% relative reduction in CRC mortality in a routine screening programme, rising to 27% in participants.British Journal of Cancer advance online publication, 26 June 2012; doi:10.1038/bjc.2012.277 www.bjcancer.com.
    Original languageEnglish
    Pages (from-to)255-259
    Number of pages5
    JournalBritish Journal of Cancer
    Volume107
    Issue number2
    DOIs
    Publication statusPublished - 10 Jul 2012

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    Occult Blood
    Hematologic Tests
    Colorectal Neoplasms
    Cohort Studies
    Mortality
    Population
    Confidence Intervals
    Health
    Scotland
    Colonoscopy
    Early Detection of Cancer
    Publications
    Age Groups
    Neoplasms

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    Libby, G. ; Brewster, D. H. ; McClements, P. L. ; Carey, F. A. ; Black, R. J. ; Birrell, J. ; Fraser, C. G. ; Steele, R. J. C. / The impact of population-based faecal occult blood test screening on colorectal cancer mortality : a matched cohort study. In: British Journal of Cancer. 2012 ; Vol. 107, No. 2. pp. 255-259.
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    title = "The impact of population-based faecal occult blood test screening on colorectal cancer mortality: a matched cohort study",
    abstract = "Background:Randomised trials show reduced colorectal cancer (CRC) mortality with faecal occult blood testing (FOBT). This outcome is now examined in a routine, population-based, screening programme.Methods:Three biennial rounds of the UK CRC screening pilot were completed in Scotland (2000-2007) before the roll out of a national programme. All residents (50-69 years) in the three pilot Health Boards were invited for screening. They received a FOBT test by post to complete at home and return for analysis. Positive tests were followed up with colonoscopy. Controls, selected from non-pilot Health Boards, were matched by age, gender, and deprivation and assigned the invitation date of matched invitee. Follow-up was from invitation date to 31 December 2009 or date of death if earlier.Results:There were 379?655 people in each group (median age 55.6 years, 51.6{\%} male). Participation was 60.6{\%}. There were 961 (0.25{\%}) CRC deaths in invitees, 1056 (0.28{\%}) in controls, rate ratio (RR) 0.90 (95{\%} confidence interval (CI) 0.83-0.99) overall and 0.73 (95{\%} CI 0.65-0.82) for participants. Non-participants had increased CRC mortality compared with controls, RR 1.21 (95{\%} CI 1.06-1.38).Conclusion:There was a 10{\%} relative reduction in CRC mortality in a routine screening programme, rising to 27{\%} in participants.British Journal of Cancer advance online publication, 26 June 2012; doi:10.1038/bjc.2012.277 www.bjcancer.com.",
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    The impact of population-based faecal occult blood test screening on colorectal cancer mortality : a matched cohort study. / Libby, G. (Lead / Corresponding author); Brewster, D. H.; McClements, P. L.; Carey, F. A.; Black, R. J.; Birrell, J.; Fraser, C. G.; Steele, R. J. C. (Lead / Corresponding author).

    In: British Journal of Cancer, Vol. 107, No. 2, 10.07.2012, p. 255-259.

    Research output: Contribution to journalArticle

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    T2 - a matched cohort study

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    AU - Brewster, D. H.

    AU - McClements, P. L.

    AU - Carey, F. A.

    AU - Black, R. J.

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    AU - Steele, R. J. C.

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    N2 - Background:Randomised trials show reduced colorectal cancer (CRC) mortality with faecal occult blood testing (FOBT). This outcome is now examined in a routine, population-based, screening programme.Methods:Three biennial rounds of the UK CRC screening pilot were completed in Scotland (2000-2007) before the roll out of a national programme. All residents (50-69 years) in the three pilot Health Boards were invited for screening. They received a FOBT test by post to complete at home and return for analysis. Positive tests were followed up with colonoscopy. Controls, selected from non-pilot Health Boards, were matched by age, gender, and deprivation and assigned the invitation date of matched invitee. Follow-up was from invitation date to 31 December 2009 or date of death if earlier.Results:There were 379?655 people in each group (median age 55.6 years, 51.6% male). Participation was 60.6%. There were 961 (0.25%) CRC deaths in invitees, 1056 (0.28%) in controls, rate ratio (RR) 0.90 (95% confidence interval (CI) 0.83-0.99) overall and 0.73 (95% CI 0.65-0.82) for participants. Non-participants had increased CRC mortality compared with controls, RR 1.21 (95% CI 1.06-1.38).Conclusion:There was a 10% relative reduction in CRC mortality in a routine screening programme, rising to 27% in participants.British Journal of Cancer advance online publication, 26 June 2012; doi:10.1038/bjc.2012.277 www.bjcancer.com.

    AB - Background:Randomised trials show reduced colorectal cancer (CRC) mortality with faecal occult blood testing (FOBT). This outcome is now examined in a routine, population-based, screening programme.Methods:Three biennial rounds of the UK CRC screening pilot were completed in Scotland (2000-2007) before the roll out of a national programme. All residents (50-69 years) in the three pilot Health Boards were invited for screening. They received a FOBT test by post to complete at home and return for analysis. Positive tests were followed up with colonoscopy. Controls, selected from non-pilot Health Boards, were matched by age, gender, and deprivation and assigned the invitation date of matched invitee. Follow-up was from invitation date to 31 December 2009 or date of death if earlier.Results:There were 379?655 people in each group (median age 55.6 years, 51.6% male). Participation was 60.6%. There were 961 (0.25%) CRC deaths in invitees, 1056 (0.28%) in controls, rate ratio (RR) 0.90 (95% confidence interval (CI) 0.83-0.99) overall and 0.73 (95% CI 0.65-0.82) for participants. Non-participants had increased CRC mortality compared with controls, RR 1.21 (95% CI 1.06-1.38).Conclusion:There was a 10% relative reduction in CRC mortality in a routine screening programme, rising to 27% in participants.British Journal of Cancer advance online publication, 26 June 2012; doi:10.1038/bjc.2012.277 www.bjcancer.com.

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