Results of Screening, Rescreening, and Follow-up in a Prospective Randomized Study for Detection of Colorectal Cancer by Fecal Occult Blood Testing: Results for 68,308 Subjects

Abstract

All 68,308 inhabitants of Göteborg born between 1918 and 1931 were randomly divided into a test and a control group. The subjects in the test group were invited to perform Hemoccult II fecal occult blood testing on 3 days and to repeat the test after 16 to 24 months. In the prevalence screening 21,347 (63%) performed the test, and in the rescreening 19,991 (60%). Investigation of the 942 (4.4%) with positive tests in the prevalence screening showed 47 cancers and 129 subjects with adenomas > or = 1.0 cm. In the rescreening 5.1% had a positive test, and 34 cancers and 122 subjects with adenomas (> or = 1.0 cm) were found among those. Cancer had also been diagnosed in 19 subjects in the interval between the two screening occasions and in 15 subjects among the non-responders. Forty-four cancers had been diagnosed in the control group during the same period. Cancers detected by screening were at a less advanced stage than in the control group. It is too early to show any effect of screening on mortality from colorectal cancer.

Colorectal cancer screening in Australia: An economic evaluation of a potential biennial screening program using faecal occult blood tests

“…A CRC stage shift from status quo to 0.26 : 0.28 : 0.32 : 0.15 (coincidentally similar to the stage distribution achieved in the Swedish study) 21 achieved this mortality reduction in our model. The fourth randomised controlled trial, the Minnesota study, 23 was excluded because the high positivity rate of their FOBT -almost 10% -resulted in 28% of the subjects having one or more colonoscopies.…”

“…Based on a meta-analysis of three of the randomised controlled trials, [20][21][22] in the presence of a screening program, it was assumed that the CRC incidence would be unchanged but the mortality rate would fall by 14%. A CRC stage shift from status quo to 0.26 : 0.28 : 0.32 : 0.15 (coincidentally similar to the stage distribution achieved in the Swedish study) 21 achieved this mortality reduction in our model.…”

Guaiac versus immunochemical tests: faecal occult blood test screening for colorectal cancer in a rural community

“…3,4 Randomised trials indicate that faecal occult blood test (FOBT) screening can reduce mortality rates by 15-35%, [5][6][7][8][9] and there is considerable interest in a national screening program for Australia.…”

Socio‐demographic correlates of screening intention for colorectal cancer

“…2,5,6 Randomised controlled trials have reported that the faecal occult blood test (FOBT) screening can reduce mortality rates by 15-33% in average-risk populations. [7][8][9][10][11] An examination of Australian data and screening outcomes for FOBT indicate that screening for CRC is comparable in cost to breast cancer screening. 12 Based on such evidence, the Australian Health Technology Advisory Committee (AHTAC) report has called for urgent research into the feasibility of FOBT for a population-based CRC screening program.…”