Clinical–alimentary tractComparing Attendance and Detection Rate of Colonoscopy With Sigmoidoscopy and FIT for Colorectal Cancer Screening
Section snippets
Study Design
The study was conducted between October 2002 and January 2004 in 6 centers in Italy (Biella, Firenze, Milano, Rimini, Torino, and Verona), following the same design adopted in a previous population-based, multicenter, randomized, controlled trial of different screening strategies.16 Approval of the study was obtained by the local ethics review committees. Briefly, in each participating center, we draw a population sample from the general practitioners’ (GP) rosters or the population registers,
Recruitment and Randomization
Of 20,042 subjects aged 55 to 64 years listed in the rosters of the 172 GPs included in the study, 1595 (8.0%) were excluded and 18,447 were randomized (Figure 1). The proportion of randomized subjects by gender in each group corresponded to the demographic structure of the source population.25 On the contrary, the age distribution is shifted toward the younger age group.
Attendance
The attendance rate was calculated over the 18,114 persons who received the invitation letter, after excluding 333 subjects
Discussion
This is the first large trial comparing uptake and neoplasia yield of TC with other recommended screening methods—FS and FIT—in an average risk population. Overall, approximately 30% of the people invited were screened. To increase the participation in screening programs, time is needed to allow for the diffusion of the reputation of the program and of the awareness of the advantages and disadvantages of the proposed intervention at the community level. On the other hand, the degree of GPs’
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Supported by a grant from the Italian League against Cancer (LILT); and by the Istituto Oncologico Romagnolo (IOR), the Fondo “E Tempia,” the University of Milan, the ULSS 20, and the Piedmont Regional Health Authority for implementation of the study in Rimini, Biella, Milan, Verona, and Turin, respectively; and by SOFAR s.p.a. for providing the enemas for the bowel preparation.
All authors declare that they have no conflict of interest to disclose.