Objectives To assess the effect 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.
Design Demonstration pilot
Setting Three Scottish NHS Boards
Participants Residents aged between 50 and 69 years registered on the Community Health Index
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 55.3%, 1.16% and 0.7/1000. In the first round the positive predictive value of a gFOBT was 12.0 % for cancer and 36.5% for adenoma; these fell to 7% and 30.3% in the second round and were maintained at 7.5% and 29.1% in the third. The percentage of screen-detected cancers diagnosed at Dukes' stage A was 49.2% in the first round, 40.1% in the second and 36.3% in the third.
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.