Sensitivity of a colorectal cancer screening program based on a guaiac test: a population-based study

Area of Science:

• Gastroenterology
• Oncology
• Public Health

Background:

• Colorectal cancer screening programs aim to detect cancer early.
• Guaiac fecal occult blood (FOB) testing is a common screening method.
• Assessing screening program sensitivity and identifying factors influencing it is crucial for improving outcomes.

Purpose of the Study:

• To estimate the sensitivity of a colorectal cancer screening program using guaiac FOB tests.
• To determine if screening sensitivity differs between males and females.
• To investigate if age, screening round, test provision, tumor location, or exclusion criteria explain sex-based sensitivity differences.

Main Methods:

• Retrospective analysis of data from a colorectal cancer screening program in Isère, France (2002-2006).
• Sensitivity assessed by analyzing interval cancers diagnosed within two years post-test.
• Logistic regression used to identify factors associated with screening program sensitivity.

Main Results:

• Overall screening sensitivity was 48.4%.
• Sensitivity was higher in males (58.3%) than females (32.5%).
• Multivariate analysis confirmed higher sensitivity in males (OR=2.1) after adjusting for covariates; 36.2% of participants had exclusion criteria.

Conclusions:

• The guaiac FOB test-based colorectal cancer screening program demonstrated insufficient sensitivity.
• A significant difference in sensitivity between males and females was observed.
• Factors such as age, screening participation characteristics, and tumor location did not fully account for the observed sex-based disparity in sensitivity.