Experiences in providing a screening service for colorectal cancer from a pathology laboratory.
OBJECTIVE
To provide a colorectal cancer screening service for the general public, based on the detection of blood in faeces, that was effective, affordable and convenient.


METHODS
Kits for collecting faecal specimens were sold directly to the public and, after collecting three specimens, kits were transported to the laboratory for testing by an immunochemical procedure involving a positive cut-off value. Reports were sent to participants and their nominated doctors who were requested to provide information on participants testing positive.


RESULTS
Over a 10-year period, 35 139 kits were analysed and 5.63% were positive. After follow-up, 7.4% of positive testing participants were found to have colorectal cancer, 23.4% adenomas, 34.6% miscellaneous non-neoplastic pathology and in 25.0% no abnormality was found. Sixty-six per cent of cancers were early stage, Dukes stages A and B. There were 35 139 kits processed on 16 240 individuals, indicating that a number were repeat testing.


CONCLUSIONS
The screening service was able to detect a high yield of colorectal pathology, especially early stage neoplasia which is curable, and encouraged repeat testing. Education of doctors about how to investigate a positive test, and of participants about symptoms, have been important lessons arising from this screening service.
Edwards
John E
JE
Division of Clinical Biochemistry, Institute of Medical and Veterinary Science, Adelaide, SA 5000, Australia. sedwards@chariot.net.au
Williams
J Anthony R
JA
Thomas
David W
DW
D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007755:Laboratories, Hospital; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009780:Occult Blood; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity
D011933:Reagent Kits, Diagnostic