Invitation for FOBt screening and colorectal cancer mortality: A prospective analysis in the Million Women Study cohort
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View abstract on PubMed
Summary
This summary is machine-generated.Women who declined bowel cancer screening had higher mortality risks. Invitation for screening did not significantly reduce overall colorectal cancer deaths, but showed benefits for distal colon cancer.
Area Of Science
- Oncology
- Public Health
- Epidemiology
Background
- The NHS Bowel Cancer Screening Programme (NHS BCSP) offers biennial guaiac faecal occult blood test (gFOBt) screening.
- Understanding factors influencing screening acceptance and its impact on colorectal cancer (CRC) mortality is crucial for public health initiatives.
Purpose Of The Study
- To examine factors associated with screening acceptance in the Million Women Study (MWS) cohort.
- To assess differences in CRC mortality based on screening invitation status within the NHS BCSP.
Main Methods
- Linked data from the MWS cohort (752,007 participants born 1940-1950) and NHS BCSP were analyzed.
- Characteristics of screening attenders and non-attenders were compared.
- CRC mortality was compared between women invited for screening and those not, using a cohort born 1935-1939 (n=246,160) over a mean follow-up of 11.9 years.
Main Results
- Women declining gFOBt screening exhibited higher deprivation and smoking levels, with a 2-fold increased risk of all-cause and CRC mortality.
- Overall, invitation for screening did not significantly reduce CRC mortality risk (RR=0.94, 95%CI 0.83-1.06) in the long term (≥4 years post-entry).
- Significant reductions in CRC mortality were observed for distal colon cancer (RR=0.64, 0.47-0.88), but not for proximal colon or rectal cancer, indicating sub-site specific effects (p=0.05 for heterogeneity).
Conclusions
- Screening acceptance is influenced by socioeconomic and lifestyle factors, with non-attenders facing higher mortality risks.
- The effectiveness of gFOBt screening in reducing overall CRC mortality appears limited in the long term.
- Further investigation into the efficacy of newer screening methods like faecal immunochemical testing (FIT) across different sexes and cancer sub-sites is warranted.
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