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Uptake of faecal immunochemical test screening among nonparticipants in a flexible sigmoidoscopy screening programme
Author(s) -
Hol Lieke,
Kuipers Ernst J.,
van Ballegooijen Marjolein,
van Vuuren Anneke J.,
Reijerink Jaqueline C.I.Y.,
Habbema Dik J.F.,
van Leerdam Monique E.
Publication year - 2011
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.26260
Subject(s) - sigmoidoscopy , medicine , confidence interval , colorectal cancer screening , test (biology) , population , screening test , family medicine , colorectal cancer , gynecology , cancer , colonoscopy , environmental health , biology , paleontology
Screening programmes based on single modality testing may prevent individuals with a preference for a different test from participating. We conducted a population‐based trial to determine whether nonparticipants in flexible sigmoidoscopy (FS) screening were willing to attend faecal immunochemical test (FIT) screening. In total, 8,407 subjects were invited in a primary FS screening programme. Invitees did not know at the time of FS invitation that nonparticipants would be offered FIT screening. A total of 4,407 nonparticipants of FS screening were invited for FIT screening (cut‐off 50 ng haemoglobin/ml). The participation rate to FS screening was 31% [95% confidence interval (CI): 30–32%]. Among the FS nonparticipants 25% (CI: 24–26%) did attended FIT screening. The participation rate of the two‐stage recruitment for FS and FIT screening was 45% (CI: 44–46%). FIT screenees were older ( p = 0.02), more often women ( p < 0.001) and had a lower social economic status ( p = 0.01) than FS screenees. The detection rate (DR) for advanced adenoma was 3.5% (CI: 2.5–4.8%), and for colorectal cancer (CRC) it was 0.3% (CI: 0.1–0.8%) among participants to FIT screening. The DR of the two‐stage recruitment was 6.1% ( n = 202) for an advanced adenoma and 0.5% ( n = 16) for a CRC. In conclusion, offering FIT screening to nonparticipants in a FS screening programme increases the overall participation rate considerably, as a quarter of nonparticipants of FS screening was willing to attend FIT screening. The participation rate remains lower for primary FIT screening in the same population (62%). Women in the target population were more likely to refuse FS than FIT screening. Countries introducing FS screening should be aware of these preferences.