An industry based approach to colorectal cancer screening in an asymptomatic population

The uptake of faecal occult blood testing in a workplace based colorectal cancer screening programme was investigated. Altogether 1828 employees aged 41-65 years at a large British industrial company were invited to receive a free faecal occult blood test (Haemoccult). Faecal occult blood tests were completed on three separate days. Patients with positive results were invited to undergo colonoscopy. The number of employees completing kits was measured and differences in compliance according to age, sex, and occupation were tested with a chi2 test. Compliance was 25.4%, and similar in men (25.0%) and women (32.0%, chi2=3.0, not significant). In men, compliance was highest in those aged 51-60 years (30.5% chi2>1.6, p<0.001). Compliance in women aged 41-50 years, 51-60 years, and 61-65 years was similar (Yates's corrected chi2<2.08, not significant). Managers returned more kits than clerical and blue collar workers (28.6% v 23.5%, chi2=5.6, p<0.02). One percent of tests were positive and one patient had a tubular adenoma. Compliance in employees aged 51-60 years was comparable to that achieved in one-off British general practice programmes, but less than that in the large randomised trial of screening in general practices in Nottinghamshire. Health education of large numbers of people is easier at the workplace than in the community. Future screening must target older employees and those with clerical and blue collar jobs.