Survival of patients diagnosed with colorectal cancer through a television-advertised screening program

Although controversial, fecal occult blood testing (FOBT) is advocated to reduce mortality due to colorectal cancer. Our aim was to determine whether a television-advertised screening program for colorectal cancer using fecal occult blood tests improved survival of patients diagnosed with colorectal cancer.

A retrospective analysis of the stage and survival of patients diagnosed with colorectal cancer in our 1986 and 1987 screening programs was conducted. The 5-yr survival rate of patients diagnosed with colorectal cancer was determined in our screened population and compared with national survival data from the National Cancer Institute Surveillance, Epidemiology, End Results (SEER) program.

In our screening programs, 75,633 FOBT were distributed and returned for analysis. Test slides were positive in 3.3%. Follow-up was available in 121 of 131 patients diagnosed with colorectal cancer. In our screened population, significantly more colorectal cancers were identified in a localized stage compared with the national average (76 vs 37%). Consequently, the percentage of our patients with regional and distant disease was decreased compared with SEER data. The overall 5-yr survival rate of patients with colorectal cancer who participated in our screening program was significantly higher than the national survival rate (75 vs 59%). Survival of patients older than 75 yr of age with colorectal cancer in our screening program was not improved.

Television-advertised screening for colorectal cancer using FOBT was effective in recruiting a large number of participants. Patients diagnosed with colorectal cancer in our program tended to have early stage disease with improved 5-yr survival. The results of this study support FOBT as an effective means to reduce the mortality of colorectal cancer.