Faecal occult blood screening and reduction of colorectal cancer mortality: a case-control study

Faivre, Jean; Tazi, M. A.; Mrini, T El; Lejeune, Catherine; Benhamiche, Anne-Marie; F, Dassonville

doi:10.1038/sj.bjc.6690107

Cited by 57 publications

(23 citation statements)

References 14 publications

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“…Reports on rates of re-participation in the literature are scarce and inconsistent, and vary depending on country and whether the data comes from randomised controlled trials, feasibility studies or full programs (Jansen, 1984;Kewenter et al, 1988;Hardcastle et al, 1996;Hart et al, 1997;Faivre et al, 1999;Mandel et al, 1999;Jorgenson et al, 2002;Weller et al, 2007;Lindholm et al, 2008;Steele et al, 2009). Some studies failed to invite firstround non-participants in subsequent rounds (Kronborg et al, 1989) although our results show that this would be unwise in organised programs because such people may become Late Entrants.…”

Section: Discussioncontrasting

confidence: 48%

Predictors of Re-participation in Faecal Occult Blood Test-Based Screening for Colorectal Cancer

Cole¹,

Gregory²,

Whibley³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Background: There is little information on longitudinal patterns of participation in faecal occult blood test (FOBT) based colorectal cancer (CRC) screening or on demographic or behavioural factors associated with participation in re-screening. The lack of an agreed system for describing participatory behaviour over multiple rounds also hampers our ability to report, understand and make use of observed associations. Our aims were to develop a system for describing patterns of participatory behaviour in FOBT-based CRC screening programs and to identify factors associated with particular behavioural patterns. Methods: A descriptive framework was developed and applied to a data extract of screening invitation outcomes over two rounds of the NBCSP. The proportion of invitees in each behaviour category was determined and associations between behaviour patterns and demographic and program factors were identified using multivariate analyses. Results: We considered ReParticipants, Dropouts, Late Entrants and Never Participants to be the most appropriate labels for the four possible observed participatory categories after two invitation rounds. The screening participation rate of the South Australian cohort of the NBCSP remained stable over two rounds at 51%, with second round Dropouts (10.3%) being balanced by Late Entrants (10.5%). Non-Participants comprised 38.7% of invitees. Relative to Re-Participants, Dropouts were older, more likely to be female, of lower SES, had changed their place of residence between offers had a positive test result in the first round. Late Entrants tended to be in the youngest age band. Conclusions: Specific demographic characteristics are associated with behavioural sub-groups defined by responses to 2 offers of CRC screening. Targeted group-specific strategies could reduce dropout behaviour or encourage those who declined the first invitation to participate in the second round. It will be important to keep first round participants engaged in order to maximise the benefit of a CRC screening program.

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Section: Discussioncontrasting

confidence: 48%

Predictors of Re-participation in Faecal Occult Blood Test-Based Screening for Colorectal Cancer

Cole¹,

Gregory²,

Whibley³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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“…Three other large trials have now been undertaken using unrehydrated tests and two have reported a more modest but highly significant 15%-20% population mortality reduction [21,22] . A recent French case-control study is also consistent with these results [23] .…”

Section: Colorectal Cancersupporting

confidence: 78%

Screening for cancer: future potential

Cuzick

1999

European Journal of Cancer

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“…[5][6][7][8][9][10][11] In one of the randomised studies a reduction in the incidence of CRC has been found. 12 For these reasons FOBT has been recommended as a screening tool for CRC [13][14][15] and several national population based screening programmes have been or are being started worldwide.…”

mentioning

confidence: 99%

Basic variables at different positivity thresholds of a quantitative immunochemical test for faecal occult blood

et al. 2002

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Objectives: Screening by faecal occult blood testing (FOBT) is effective in decreasing mortality and incidence of colorectal cancer (CRC). Immunochemical tests have proved to be more cost effective than guaiac FOBTs. The latex agglutination test (LAT) has the advantage of being a fully automated, quantitative test. The aim of this study is to interpret the overall experience with LAT according to different positivity thresholds. Setting: A population based screening programme is currently running involving subjects aged 50-70, invited every 2 years to have an FOBT. LAT is the standard screening test and has a positivity threshold for further diagnostic tests of 100 ng haemoglobin/ml of sample solution. Methods: Positivity rates, detection rates for CRC high risk adenomas, and positive predictive values for CRC, high risk adenomas, and low risk adenomas were calculated for several positivity thresholds. Results: 19 132 attendances at screening were recorded (11 774 at first screening, 7358 at subsequent screenings). Progressively increasing the positivity threshold from 100 to 200 ng/ml showed (a) a decrease in positivity rate; (b) a decrease in detection rates for CRC or high risk adenomas; (c) an increase in positive predictive values for cancer; (d) an increase in positive predictive value for high risk adenomas. Conclusions: Increasing the positivity threshold of the LAT reduces recall rate and improves positive predictive value for cancer or high risk adenomas but substantially decreases the detection rate of CRC and high risk adenomas. For this reason increasing the positivity cut off for LATs is not advisable. On the other hand decreasing the positivity threshold would increase recall rate and sensitivity of screening. Careful evaluation of sensitivity of the quantitative results of the LAT for interval cancers is needed to definitively assess the optimal positivity threshold for LATs in population based screening programmes.

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Faecal occult blood screening and reduction of colorectal cancer mortality: a case-control study

Cited by 57 publications

References 14 publications

Predictors of Re-participation in Faecal Occult Blood Test-Based Screening for Colorectal Cancer

Predictors of Re-participation in Faecal Occult Blood Test-Based Screening for Colorectal Cancer

Screening for cancer: future potential

Basic variables at different positivity thresholds of a quantitative immunochemical test for faecal occult blood

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