Effect of faecal occult blood screening on mortality from colorectal cancer: results from a randomised controlled trial.
BACKGROUND
Three large randomised trials have shown that screening for colorectal cancer using faecal occult blood (FOB) tests can reduce the mortality from this disease. Two national pilot studies have recently been launched in the UK to investigate the feasibility of population screening for colorectal cancer in the National Health Service. The largest of the randomised trials was conducted in Nottingham and randomised 152 850 individuals between the ages of 45 and 74 years to receive biennial Haemoccult (FOB) test kit (intervention group) or to a control group.


OBJECTIVE
We have compared the mortality in the intervention group compared with the control group.


METHODS
The 152 850 randomised individuals were followed up through local health records and central flagging (Office for National Statistics) over a median follow up period of 11 years.


RESULTS
At a median follow up of 11 years there was a 13% reduction in colorectal cancer mortality (95% confidence interval 3-22%) in the intervention group despite an uptake at first invitation of only approximately 50%. The mortality reduction for those accepting screening was 27%. The reduction in mortality was independent of sex and site of tumour. There was no significant difference in mortality from causes other than colorectal cancer between the intervention and control groups.


CONCLUSIONS
Although the reduction in colorectal cancer mortality was sustained, further follow up of this population is required to determine whether a significant reduction in the incidence of colorectal cancer will be achieved.
Scholefield
J H
JH
Division of GI Surgery, University Hospital, Nottingham NG7 2UH, UK. john.scholefield@nottingham.ac.uk
Moss
S
S
Sufi
F
F
Mangham
C M
CM
Hardcastle
J D
JD
D000368:Aged; D002423:Cause of Death; D015179:Colorectal Neoplasms / Q000401:mortality / Q000517:prevention & control*; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009780:Occult Blood; D012307:Risk Factors