Use of a faecal immunochemical test narrows current gaps in uptake for sex, age and deprivation in a bowel cancer screening programme

Abstract

Objectives To investigate the characteristics of participants screened for bowel cancer using a faecal immunochemical test for haemoglobin (FIT). Setting Scottish Bowel Screening Programme. Methods 65909 men and women in two NHS Boards, aged 50 to 74, were invited to participate in an evaluation of FIT as a first-line test. Uptake was calculated by sex, age in quintiles, and deprivation in quintiles, and compared with a group who had completed a guaiac faecal occult blood test (gFOBT) and for whom details of sex, age and deprivation were well documented. Results FIT kits from 38672 participants were tested. The overall uptake of 58.7% was significantly higher than the 53.9% for gFOBT (p , 0.0001). Uptakes in the two NHS Boards were 57.6% and 54.4% for men and 63.2% and 59.1% for women, higher than the 49.5% and 58.1% completing gFOBT. Uptake was higher for FIT than gFOBT in all age and deprivation quintiles for both men and women in both NHS Boards. The difference in uptake fell with age for men but rose for women; the increase in uptake was greater for men than women. Uptake fell as deprivation decreased for both sexes, and was similar in both NHS Boards. Conclusions Use of FIT increases uptake over gFOBT, and the greatest increases are seen in men, younger participants, and more deprived individuals, groups for which an increase in uptake is likely to be beneficial. The results support a move to FIT as a first-line screening test for those countries still using gFOBT.

Sustained participation, colonoscopy uptake and adenoma detection rates over two rounds of the Tallaght–Trinity College colorectal cancer screening programme with the faecal immunological test

“…The actual participation rates for each round are in keeping those reported previously for FIT [30,31]. Similarly, there were no significant changes in the sex or age profile of the respondents between the two rounds.…”

Increased uptake and improved outcomes of bowel cancer screening with a faecal immunochemical test: results from a pilot study within the national screening programme in England

“…Of these, the two largest studies, both in the Netherlands, which found uptake to increase from 46.9% or 49.5% with gFOBt to 59.6% or 61.5% with FIT, were both conducted in previously unscreened populations 13 15. A study in Scotland has reported overall uptake of 58.7% with FIT compared with 53.9% for gFOBt, with higher uptake in all age and deprivation quintiles for both men and women 18 19. However, in the Scottish study FIT uptake and clinical outcomes in two evaluation NHS boards were compared with results obtained contemporaneously in two other similar NHS boards and before and after the evaluation of FIT.…”

Invitation strategies for colorectal cancer screening programmes: The impact of an advance notification letter

“…The pre-notification letter was associated with a marked increase (from 53.9% to 59.0% -OR = 1.24) in the response to the invitation for gFOBT screening in the Scottish programme (Libby et al, 2011), with a similar trend by age, gender, SES and screening history. However, a recent report (Digby et al, 2013) from the same programme, showing that, maintaining the standard invitation procedure, a comparable increase in the participation (from 53.9% to 58.7%) could be achieved by offering FIT as compared to gFOBT, would suggest that the impact of a pre-notification letter might be lower when adopting a more acceptable strategy (single sample and simplified stool collection procedure).…”