Screening for colorectal cancer using the faecal occult blood test, Hemoccult

Towler, BP; Irwig, Les; Glasziou, Paul; Weller, David; Kewenter, J

doi:10.1002/14651858.cd001216

Cited by 77 publications

(80 citation statements)

References 20 publications

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“…Such studies should also investigate what screening methods and locations are most acceptable to obese patients (as well as non-obese patients). It may be premature to abandon fecal occult blood testing, which has been shown to decrease colon cancer mortality in prospective randomized controlled trials, [39] and sigmoidoscopy, which has been shown to decrease mortality in case-control trials. [40][41][42] Both of these are less invasive than colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

Colorectal cancer screening among obese versus non-obese patients in primary care practices

Ferrante

Ohman‐Strickland

Hudson

et al. 2006

Cancer Detection and Prevention

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Section: Discussionmentioning

confidence: 99%

Colorectal cancer screening among obese versus non-obese patients in primary care practices

Ferrante

Ohman‐Strickland

Hudson

et al. 2006

Cancer Detection and Prevention

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“…50% for carcinomas). However data are available suggesting that use of FOBT detects colorectal lesions at an earlier stage, and that screened lesions are associated with survival benefits (Towler et al, 1998).…”

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confidence: 99%

Elevated serum matrix metalloproteinase 9 (MMP-9) concentration predicts the presence of colorectal neoplasia in symptomatic patients

et al. 2007

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Early detection of polyps or colorectal carcinoma can reduce colorectal carcinoma-associated deaths. Previous studies have demonstrated raised serum levels of matrix metalloproteinase 9 (sMMP-9) in a range of cancers. The aim of this study was to investigate the role of sMMP-9 levels in identifying colorectal neoplasia. Consenting patients donated a blood sample and were assessed by proforma-led history and physical examination. Samples were analysed for sMMP-9 concentration (enzyme-linked immuno-sorbant assay) and compared to final diagnoses. Logistic regression modelling determined independent factors associated with neoplasia. A total of 365 patients were recruited of whom 300 were analysed, including 46 normal controls. A total of 27 significant adenomas and 63 malignancies were identified. The median sMMP-9 concentration was 443ng ml À1 (IQR: 219 -782; mean: 546). Patients with neoplasia had significantly elevated sMMP-9 levels (Po0.001). Logistic regression modelling identified elevated log(sMMP-9) as the most significant predictor of neoplasia (w 2 ¼ 38.33, Po0.001). Other significant factors were age, sex, smoking history, abdominal pain and weight loss. The model accurately predicted neoplasia in 77.3% of cases. Sensitivity and specificity were 77.9 and 77.1%. sMMP-9 estimation can accurately stratify patient to low-or high-risk cohorts. Serum sampling is a potential means of avoiding unnecessary colonoscopy and reducing patient anxiety, iatrogenic morbidity and mortality, and cost.

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“…A recent meta-analysis estimates that the reduction in mortality may be in the range of 16% to 20% (Towler et al, 2000) a relatively small benefit. In the 2 above-cited population-based trials the sensitivity of the programme among the participants was 55% in Funen (Gyrd-Hansen et al, 1997) and 51% in Nottingham (Moss et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

Estimation of screening test (Hemoccult®) sensitivity in colorectal cancer mass screening

Jouve

Remontet²,

Dancourt

et al. 2001

Br J Cancer

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Summary 3 controlled cohorts of mass-screening for colorectal cancer using a biennial faecal occult blood (HemoccultII ® ) test on well-defined European populations have demonstrated a 14% to 18% reduction in specific mortality. We aimed to estimate the sensitivity (S) of this HemoccultII ® test and and also mean sojourn time (MST) from French colorectal mass-screening programme data. 6 biennial screening rounds were performed from 1988 to 1998 in 45 603 individuals aged 45-74 years in Saône-et-Loire (Burgundy, France). The prevalent/incidence ratio was calculated in order to obtain a direct estimate of the product S.MST. The analysis of the proportional incidence and its modelling was used to derive an indirect estimate of S and MST. The product S.MST was higher for males than females and higher for left colon than either the right colon or rectum. The analysis of the proportional incidence confirmed the result for subsites but no other significant differences were found. The sensitivity was estimated at 0.57 and the MST at 2.56 years. This study confirms that the sensitivity of the Hemoccult test is relatively low and that the relatively short sojourn time is in favour of annual screening.

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Screening for colorectal cancer using the faecal occult blood test, Hemoccult

Cited by 77 publications

References 20 publications

Colorectal cancer screening among obese versus non-obese patients in primary care practices

Colorectal cancer screening among obese versus non-obese patients in primary care practices

Elevated serum matrix metalloproteinase 9 (MMP-9) concentration predicts the presence of colorectal neoplasia in symptomatic patients

Estimation of screening test (Hemoccult®) sensitivity in colorectal cancer mass screening

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