title: Colorectal cancer screening by guaiac faecal occult blood test in France: Evaluation of the programme two years after launching.
abstract: BACKGROUND
  The French national screening programme for colorectal cancer (CRC) was rolled out nationwide from 2008. It targets men and women aged 50-74 who are invited every 2 years to perform a guaiac faecal occult blood test, followed, if positive, by a colonoscopy. This paper presents the evaluation of the programme for the 46 French districts that conducted a comprehensive screening campaign during 2008-2009, targeting 9.7 million people.
  
  
  METHODS
  National database gathering information on people who were screened was used to estimate indicators reflecting the programme performance.
  
  
  RESULTS
  Participation was 34.3%, with nearly three million people being tested. The percentage of positive tests was 2.8%. Completion of colonoscopies following a positive test was 88%. For men, 36.8% of the results of colonic explorations were normal, 40.1% were adenomas, and 9.0% were CRC, based on the most pejorative lesion. For women, corresponding figures were 55.9%, 25.7% and 5.8%. A CRC was detected for 7.5% of people who had a colonic exploration. The advanced adenoma detection rate among those screened was 4.9‰ and the CRC detection rate was 1.9‰. The description of CRC could only be made for 21 districts, for which 1441 invasive colonic adenocarcinomas were diagnosed; of these, 43% were stage I, 23% stage II, 25% stage III and 9% stage IV.
  
  
  CONCLUSIONS
  This first evaluation since the programme was rolled out provides an inventory of CRC screening in France and points out some improvements expected, especially in terms of participation which is below the European recommendations. Future evaluations will analyse trends in these indicators.
authors.affiliation: Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, Saint-Maurice, France.
authors.forename: Klervi
authors.initials: K
authors.lastname: Leuraud
authors.forename: Delphine
authors.initials: D
authors.lastname: Jezewski-Serra
authors.forename: Jérôme
authors.initials: J
authors.lastname: Viguier
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Salines
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000517:prevention & control; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006138:Guaiac; D006801:Humans; D007202:Indicators and Reagents; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D009780:Occult Blood; D011379:Prognosis; D013997:Time Factors
chemical_list: D007202:Indicators and Reagents; D006138:Guaiac
keywords: Adenocarcinoma; Colonoscopy; Colorectal cancer; Guaiac test; Screening