Colorectal cancer screening: strategies to select populations with moderate risk for disease.
OBJECTIVE
to analyse the association between rectal bleeding or a family history of colorectal cancer (CRC) and the results obtained in two rounds of a CRC screening pilot programme performed in L Hospitalet, Barcelona, Spain.


METHODS
males and females (50-69 years) were the target population. Together with the invitation letter, they received a questionnaire in which they were asked about rectal bleeding, family history of CRC and related neoplasms. The screening test was a guaiac-based faecal occult blood test (FOBT), and colonoscopy for positive tests.


RESULTS
25,829 FOBT were performed in 18,405 individuals. Information on rectal bleeding and a family history of CRC were obtained for 9,849 and 9,865 cases, respectively. Male sex (OR = 1.32), 60-69 years of age (OR = 1.48), rectal bleeding (OR = 1.84) and history of CRC (OR = 1.54) were independent predictors of positive FOBT. With regard to colonoscopy, a greater risk of diagnosing advanced neoplasm was observed among men (OR = 2.47) and subjects with a family history of CRC (OR = 1.98).


CONCLUSIONS
CRC screening programmes must have instruments that make it possible to select the candidate population and the possibility of offering a study suited to the risk of individuals who are not susceptible to population screening by means of FOBT.
Navarro
M
M
Cancer Prevention and Control Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain.
Binefa
G
G
Blanco
I
I
Guardiola
J
J
Rodríguez-Moranta
F
F
Peris
M
M
D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000235:genetics; D003627:Data Interpretation, Statistical; D005260:Female; D006470:Hemorrhage; D006801:Humans; D008297:Male; D008403:Mass Screening; D009780:Occult Blood; D010865:Pilot Projects; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology