Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer.
OBJECTIVE
To assess the effects of the first three rounds of a pilot colorectal screening programme based on guaiac faecal occult blood testing (gFOBT) and their implications for a national population-based programme.


METHODS
A demonstration pilot programme was conducted in three Scottish NHS Boards. Residents aged between 50 and 69 years registered on the Community Health Index were included in the study.


RESULTS
In the first round, the uptake was 55.0%, the positivity rate was 2.07% and the cancer detection rate was 2.1/1000 screened. In the second round, these were 53.0%, 1.90% and 1.2/1000, respectively, and in the third round, 55.3%, 1.16% and 0.7/1000, respectively. In the first round, the positive predictive value of the gFOBT was 12.0% for cancer and 36.5% for adenoma; these fell to 7.0% and 30.3% in the second round and were maintained at 7.5% and 29.1% in the third round. The percentage of screen-detected cancers diagnosed at Dukes' stage A was 49.2% in the first round, 40.1% in the second round and 36.3% in the third round.


CONCLUSIONS
These results are compatible with those of previous randomised trials done in research settings, demonstrating that population-based colorectal cancer screening is feasible in Scotland and should lead to a comparable reduction in disease-specific mortality.
Steele
R J C
RJ
Department of Surgery, University of Dundee, Dundee, UK. r.j.c.steele@dundee.ac.uk
McClements
P L
PL
Libby
G
G
Black
R
R
Morton
C
C
Birrell
J
J
Mowat
N A G
NA
Wilson
J A
JA
Kenicer
M
M
Carey
F A
FA
Fraser
C G
CG
D000368:Aged; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D042241:Early Diagnosis; D005240:Feasibility Studies; D005260:Female; D006138:Guaiac; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D009780:Occult Blood; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015397:Program Evaluation; D011933:Reagent Kits, Diagnostic; D012606:Scotland / Q000453:epidemiology; D013222:State Medicine / Q000458:organization & administration
D011933:Reagent Kits, Diagnostic; D006138:Guaiac