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Screening for colorectal cancer--the Nottingham experience
1Department of Surgery, University Hospital, Nottingham, United Kingdom.
Annals of the Academy of Medicine, Singapore
|July 1, 1987
Summary
Screening for colorectal cancer using fecal occult blood (FOB) tests in asymptomatic individuals significantly increased early-stage tumor detection. Long-term follow-up is needed to determine the impact on mortality rates.
Area of Science:
- Oncology
- Gastroenterology
- Public Health
Background:
- Advanced stage at presentation leads to poor prognosis in most colorectal cancer patients.
- Nonspecific symptoms and diagnostic delays contribute to late detection.
- Previous FOB testing in symptomatic patients reduced diagnostic delay but not cancer stage.
Purpose of the Study:
- To evaluate the effectiveness of asymptomatic screening using fecal occult blood (FOB) tests for early colorectal cancer detection.
- To assess the pathological stage of colorectal cancers detected through screening compared to standard care.
Main Methods:
- A randomized controlled trial involving 26,975 individuals aged 45-75 years.
- Participants were randomized to receive FOB tests or serve as controls.
- FOB test completion rate was 36% (4,917 participants).
Main Results:
- 18 colorectal cancers were detected in the FOB test group, with 13 (72%) confined to the bowel wall.
- An additional six cancers (3 Stage A) were found upon rescreening.
- In the control group, 20 cancers were diagnosed over two years, with only one (5%) being Stage A.
Conclusions:
- Asymptomatic screening with FOB tests significantly increases the detection of early-stage colorectal tumors.
- The study demonstrates a higher proportion of early-stage cancers in the screened group.
- Long-term follow-up is required to ascertain the impact of FOB screening on colorectal cancer mortality.