Faecal occult blood test-based screening programme with high compliance for colonoscopy has a strong clinical impact on colorectal cancer.
BACKGROUND
The results of a pilot colorectal cancer screening programme by biennial immunochemical faecal occult blood test (FOBT) are reported.


METHODS
All residents aged between 50 and 69 years in the Italian province of Lecco were invited to have a FOBT. Those with a positive result were offered colonoscopy. FOBT uptake and compliance with colonoscopy were assessed. Detection rate and positive predictive value (PPV) for cancer and adenoma were calculated. Tumour stages were compared between screen-detected cancers and other colorectal cancers diagnosed within the target age group.


RESULTS
Some 38,693 (49.6 per cent) of 78,083 individuals had a FOBT and 2392 (6.2 per cent) had a positive result. Colorectal cancer was diagnosed in 4.6 per cent and advanced adenoma in 32.7 per cent. PPVs were 4.0 per cent for cancer, 28.1 per cent for advanced adenoma and 36.6 per cent for any adenoma. There was a significant difference in incidence of stage III/IV disease between screened and non-screened cohorts. Compliance for colonoscopy was 92.0 per cent. Major determinants of compliance were age less than 59 years, female sex, high education level and non-manual work.


CONCLUSIONS
These results justify extension of colorectal cancer screening to other regions of Italy.
Gastrointestinal Unit, Alessandro Manzoni Hospital, Lecco, Italy. f.parente@ospedale.lecco.it
F
F
Parente
B
B
Marino
N
N
DeVecchi
R
R
Moretti
G
G
Ucci
P
P
Tricomi
A
A
Armellino
L
L
Redaelli
S
S
Bargiggia
E
E
Cristofori
E
E
Masala
F
F
Tortorella
A
A
Gattinoni
F
F
Odinolfi
M E
ME
Pirola
D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D004522:Educational Status; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009780:Occult Blood; D010349:Patient Compliance / Q000706:statistics & numerical data; D010865:Pilot Projects; D017678:Sex Distribution