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  1. Grazia Grazzini1,
  2. Marco Zappa2,
  3. Leonardo Ventura2,
  4. Tiziana Rubeca3,
  5. Stephen P Halloran4
  1. 1Screening Department, Cancer Prevention and Research Institute (ISPO), Florence, Italy
  2. 2Clinical and Descriptive Epidemiology Department, Cancer Prevention and Research Institute (ISPO), Florence, Italy
  3. 3Bio-molecular and analytical cytology laboratory, Cancer Prevention and Research Institute (ISPO), Florence, Italy
  4. 4Bowel Cancer Screening Southern Programme Hub, Postgraduate Medical School, University of Surrey, Guildford, Surrey, UK
  1. Correspondence to Grazia Grazzini, Department of Screening, ISPO Cancer Prevention and Research Institute, Viale A Volta 171, 50131 Firenze, Italy; g.grazzini{at}

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We thank Drs van Rossum and van Oijen for comparing and contrasting our observations on seasonal variations in the performance of faecal occult blood tests in colorectal cancer screening with theirs.1 While we both have observed variations, our data show significantly lower positivity and pathology detection rates during the hot Italian summer months whereas the Dutch authors noted a smaller change during the winter months.

Seasonal variations in …

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