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Colorectal cancer detection in a Community Hospital Screening Program

J E Kurnick, L B Walley, H H Jacob

    JAMA
    |May 23, 1980
    PubMed
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    Colorectal cancer screening using stool occult blood testing detected 16 cases in 5,595 individuals. While valuable, this method does not identify all colon cancers, underscoring the need for further diagnostic procedures.

    Area of Science:

    • Gastroenterology
    • Oncology
    • Preventive Medicine

    Background:

    • Colorectal cancer remains a significant health concern, necessitating effective screening strategies.
    • Early detection of colorectal neoplasms is crucial for improving patient outcomes.
    • Cancer detection centers play a vital role in population health surveillance.

    Purpose of the Study:

    • To evaluate the efficacy of stool occult blood testing in detecting colorectal cancer.
    • To determine the yield of colorectal cancer cases within a community hospital screening program.
    • To assess the limitations of stool occult blood testing in identifying all colonic neoplasms.

    Main Methods:

    • Analysis of data from 5,595 individuals screened at a community hospital cancer detection center over 4.5 years.

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  • Review of diagnostic findings, including proctosigmoidoscopy and stool occult blood testing.
  • Correlation of screening results with confirmed colorectal cancer diagnoses.

    • Main Results:

    • Sixteen cases of colorectal cancer were identified among 5,595 individuals examined.
    • Of the 16 cancer patients, 9 had positive stool occult blood tests, yielding a 7.5% detection rate among those with positive results.
    • Six patients with confirmed cancer had negative stool occult blood tests, highlighting a limitation of the screening method.

    Conclusions:

    • Stool occult blood testing is a valuable tool for colorectal cancer screening but has limitations.
    • Symptoms such as pain, altered bowel habits, or tenesmus warrant further investigation with sigmoidoscopy or barium enema, regardless of stool test results.
    • A multimodal approach combining screening tests and clinical evaluation is essential for comprehensive colorectal cancer detection.