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PTU-050 Patients with interval colorectal cancers(crc) ‘missed’ on the national faecal occult blood (fob) screening programme have a worse outcome in the short-term compared to patients who declined to join the programme – results from a multicentre study
  1. AT George1,2,3,
  2. S Aggarwal3,
  3. S Dharmavaram3,
  4. A Menon3,
  5. M Dube3,
  6. M Vogler4,
  7. A Field4
  1. 1General Surgery, QMC University Hospital NHS Trust, Nottingham
  2. 2General Surgery, Royal Derby Hospital NHS Trust, Derby
  3. 3General Surgery, Sherwood Forest NHS Trust, Mansfield
  4. 4Bowel Cancer Screening Programme (Eastern Hub), QMC University Hospital NHS Trust, Nottingham, UK


Introduction To compare outcomes of the two groups

Method National Bowel Cancer Audit Programme data from three centres,for all colorectal cancers(CRC)in the screening age group(60–74 years)over a 2 year period(August 2011–2013)were linked for their Faecal Occult Blood Testing(FOBT)screening status(BCSP database/Eastern Hub).Patient/tumour demographics and survival for Interval cancers(IC-screening patients developing cancers within 2 years of a negative FOB test)and cancers in those who declined the screening programme were analysed.All three centres were in incident rounds of screening.Tumours at and beyond splenic flexure were considered left-sided. 1 year mortality was looked at as all patients had a minimum of 1 year follow-up.

Results Of the 521 CRC identified, 127 (25%)were IC and 228 (44%)were cancers in the declined screening group.The mean age at cancer diagnosis(66.8 years vrs 67.5 years;p=0.014 ,X2= 0.33);male:female ratio(83:44vrs 130:98;p =0.024 ,X2= 2.36)and ethnic demographics(white british:others;123:5vrs211:20; p=0.090 ,X2= 2.87)between the IC and declined screening groups were comparable.Between the IC and Declined Screening groups,the tumour location(right-sided:left-sided;48:79vrs 66:162;p =0.024 ,X2= 2.36)and polyp:non-polyp cancers(2:125vrs 1:227;p =0.262 ,X2= 1.25)were comparable.

The IC had a higher proportion of advanced cancers at presentation(Dukes C/D;89 (70%)vs122(53%);p= 0.002 ,X2 = 9.28 )compared to the declined screening group.

Mortality-data 1 year mortality was 20 (16%)and 25 (11%)for the IC and declined screening groups respectively.There was no gender,age or ethnic differences between the two groups.The mortality of right-sided cancers in the IC group was significantly higher than that for the declined screening group(10 (21%)vrs 4 (6%);p= 0.037 ,X2 = 4.32 ).

Conclusion Our findings highlight that patients on the national FOBT screening programme who develop IC (specially right-sided)fared worse in the short-term, compared to CRC in patients who had declined FOBT screening-due to a higher tumour stage and a higher 1 year mortality.

Disclosure of Interest None Declared

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