Acceptability and compliance in screening for colorectal cancer with fecal occult blood test

To evaluate acceptability of and compliance with the Hemoccult-II guaiac test in screening for occult fecal blood, a representative sample of 685 persons 40-74 years old received slides and invitation without previous notice. Sixty-seven per cent accepted. Eight persons (1.7%) had a positive test. Two had rectal cancer, and two had adenomas. Acceptability decreased significantly with age in women but not in men. Eighty-seven per cent agreed to repeated screenings with intervals of 1-2 years. The acceptability was favorable compared with other studies and suggests 70-74 years as the upper limit for screening. Acceptability may even be increased by further information to the population. Written reminders were effective, but telephone calls were not. Compliance was high, since only 20 persons needed further instructions, and the proportion of false-positive tests suggested that dietary instructions had been followed. The high acceptability favors the planning of a major randomized trial of the possible effect of screening on mortality from colorectal cancer.