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Screening for colorectal cancer
Matti Hakama1, Geir Hoff, Ole Kronborg
1Finnish Cancer Registry Institute for Statistical and Epidemiological Cancer research, Helsinki, Finland. matti.hakama@uta.fi
Acta Oncologica (Stockholm, Sweden)
|August 25, 2005
Summary
Colorectal cancer (CRC) screening using the fecal occult blood test (FOBT) shows significant mortality reduction. Further research is needed on public health service effectiveness and costs.
Area of Science:
- Oncology
- Public Health
- Gastroenterology
Background:
- Colorectal cancer (CRC) is a leading cause of cancer death in Nordic countries.
- Early detection and precursor removal (adenomas) can cure or prevent CRC.
- CRC screening meets many criteria for effective population-based health interventions.
Purpose of the Study:
- To evaluate the efficacy and effectiveness of fecal occult blood test (FOBT) screening for colorectal cancer.
- To assess the impact of CRC screening on mortality rates.
- To examine the feasibility and cost-effectiveness of population-based CRC screening programs.
Main Methods:
- Review of randomized controlled trials (RCTs) using Hemoccult-II for CRC screening.
- Analysis of long-term follow-up data on CRC mortality reduction.
- Examination of public health policies and feasibility studies in Nordic countries (Denmark, Finland, Norway, Sweden).
Main Results:
- Biennial FOBT screening (Hemoccult-II) demonstrated a 15-18% CRC mortality reduction in targeted populations.
- Attended screening showed an estimated 23% mortality reduction.
- Evidence supports FOBT efficacy, but effectiveness in public health services and cost-benefit analyses require further investigation.
Conclusions:
- Fecal occult blood test screening is effective in reducing colorectal cancer mortality.
- Population-based screening feasibility studies are underway in some Nordic countries.
- More research is needed on the real-world effectiveness, harms, and costs of public health CRC screening programs.