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Fecal occult blood screening for colorectal cancer in the general population results of a controlled trial
Author(s) -
Hardcastle J. D.,
Armitage N. C.,
Chamberlain J.,
Amar S. S.,
James P. D.,
Balfour T. W.
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19860715)58:2<397::aid-cncr2820580235>3.0.co;2-x
Subject(s) - medicine , asymptomatic , colorectal cancer , stage (stratigraphy) , fecal occult blood , cancer , population , occult , gastroenterology , colonoscopy , pathology , paleontology , alternative medicine , environmental health , biology
A total of 26,975 asymptomatic individuals were identified from family doctors' age/sex registers and randomly allocated to test or control group. The first test group (10,253) were offered 3‐day fecal occult blood (FOB) testing; 3,613 (37%) completed the tests and 77 (2.1%) were found to be positive. In this group, 13 cancers were detected (3.5/1000 persons screened), of which 9 (70%) were Stage A; Of these subjects, 3349 have been rescreened at 2 years; 2799 (85%) completed the tests and 80 (2.8%) were found to be positive. Four cancers have been detected (three Stage A). In the whole test group followed for 2 years (10,462), 34 cancers have presented (17 screening detected, 3 interval cases in test responders, 14 symptomatic cancers in nonresponders), of which 14 (43%) were Stage A. In the control group (10,272 individuals), 17 patients have presented with symptomatic colorectal cancer during the 2‐year follow‐up, with rates of 0.9/1000 and 0.8/1000 persons/year in the first and second years of follow‐up, respectively. No Stage A tumors were present. In the second test group (3,225) offered both guaiac (Hemoccult; Smith Kline Diagnostics) and immunologic (Feca EIA; Nordic) FOB tests, 1304 (44%) completed the tests, of which 126 (9.7%) were positive. Five cancers were detected (four Stage A), of which only three were positive by Hemoccult testing. In this group of test responders, one cancer has presented symptomatically at 1 year follow‐up. Thus, at 2‐year follow‐up of the responding individuals of both cohorts of the initial screen of the test group, 5 of 21 cancers (24%) were negative by Hemoccult testing. Fecal occult blood testing has doubled the detection of colorectal cancer in the test group compared with the number presenting with symptoms in 2 years in the control group, and increased the proportion of early stage cancers (x 2 = 8.0, P = < 0.001). Cancer 58:397–403, 1986.