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Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer
  1. R J C Steele1,2,3,
  2. P L McClements4,
  3. G Libby3,4,
  4. R Black4,
  5. C Morton5,
  6. J Birrell5,
  7. N A G Mowat6,
  8. J A Wilson7,
  9. M Kenicer8,
  10. F A Carey9,
  11. C G Fraser2
  1. 1
    Department of Surgery, University of Dundee, Dundee, UK
  2. 2
    Scottish Bowel Screening Centre, UK
  3. 3
    Bowel Screening Research Unit, Scottish Bowel Screening Centre, UK
  4. 4
    Information Services, NHS National Services Scotland, UK
  5. 5
    NHS National Services Scotland, UK
  6. 6
    Department of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen, UK
  7. 7
    Department of Gastroenterology, Victoria Hospital, Kirkaldy, UK
  8. 8
    Department of Public Health, NHS Tayside, Dundee, UK
  9. 9
    Department of Pathology, University of Dundee, Dundee, UK
  1. Professor R J C Steele, Department of Surgery and Molecular Oncology, Level 6, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK; r.j.c.steele{at}dundee.ac.uk

Abstract

Objectives: 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.

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Footnotes

  • Competing interests: None.

  • Funding: This work was supported in part by a grant from the Chief Scientist Office, Scottish Government Health Department, to establish a Bowel Screening Research Unit.

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