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Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer
  1. Robert JC Steele (r.j.c.steele{at}dundee.ac.uk)
  1. University of Dundee, United Kingdom
    1. Paula McClements (paula.mcclements{at}isd.csa.scot.nhs.uk)
    1. Information Services, NHS National Services, Scotland, United Kingdom
      1. Gillian Libby (g.libby{at}dundee.ac.uk)
      1. Bowel Screening Research Unit, Scottish Bowel Screening Centre, United Kingdom
        1. Roger Black (roger.black{at}isd.csa.scot.nhs.uk)
        1. Information Services, NHS National Services, Scotland, United Kingdom
          1. Carole Morton (carole.morton{at}nhs.net)
          1. NHS National Services Scotland, United Kingdom
            1. Janice Birrell (janice.birrell{at}isd.csa.scot.nhs.uk)
            1. NHS National Services Scotland, United Kingdom
              1. Ashley NG Mowat (ashley.mowat{at}arh.grampian.scot.nhs.uk)
              1. Aberdeen Royal Infirmary, United Kingdom
                1. John Wilson (ja.wilson{at}faht.scot.nhs.uk)
                1. Victoria Hospital, Kirkaldy, United Kingdom
                  1. Margaret Kenicer (mkenicer{at}nhs.net)
                  1. NHS Tayside, United Kingdom
                    1. Frank A Carey (frank.carey{at}nhs.net)
                    1. University of Dundee, United Kingdom
                      1. Callum G Fraser (callum.fraser{at}nhs.net)
                      1. Scottish Bowel Screening Centre, United Kingdom

                        Abstract

                        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.

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