Screening for colorectal cancer in a factory-based population with Fecatest

This report concerns a screening programme for colorectal cancer using Fecatest, a relatively sensitive test for faecal occult blood, in a factor-based population. A total of 2420 workers between 40 and 65 years of age returned kits for testing following suitable dietary restriction. In Factory A, in which screening was offered as part of an annual medical examination, 989 men agreed to participate, a compliance rate of 45%. In Factory B, in which screening was offered in their weekly pay packets, 1431 men participated, a compliance rate of 22%. An overall positivity rate of 5.8% was found, 4.6% in Factory A and 6.6% in Factory B. Five cancers were found, two of the rectum, one at the recto-sigmoid junction, one in the sigmoid colon and one in the transverse colon. Two of these lesions were at Dukes Stage A, one at Stage B and two at Stage C. In addition, 25 adenomatous polyps were found in 17 men. In 13 these were characterized as tubular adenomata and in 4 as tubulovillous adenomata. The mean age at diagnosis in the polyp cases was 52.6 years and in the cancer cases 58.8 years. Increased specificity is obtained by excluding participants below 46 years of age. The detection rate in the 46-65 year range is approximately 1 in 100 for adenomatous polyps and 1 in 300 for cancer in the population screened. This detection rate is higher than most comparable studies using a less sensitive Guaiac test on older populations.