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Stage distribution of screen-detected colorectal cancers in the Netherlands
  1. Esther Toes-Zoutendijk1,
  2. Arthur I Kooyker1,2,
  3. Marloes A Elferink3,
  4. Manon C W Spaander4,
  5. Evelien Dekker5,
  6. Harry J de Koning1,
  7. Valery E Lemmens1,3,
  8. Monique E van Leerdam2,
  9. Iris Lansdorp-Vogelaar1
  10. on behalf of LECO working group
    1. 1 Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
    2. 2 Department of Gastroenterology and Hepatology, Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
    3. 3 Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
    4. 4 Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
    5. 5 Department of Gastroenterology and Hepatology, Amsterdam Medical Center, Rotterdam, The Netherlands
    1. Correspondence to Esther Toes-Zoutendijk, Department of Public Health, Erasmus MC University Medical Center, Rotterdam 3000 CA, The Netherlands; e.toes-zoutendijk{at}erasmusmc.nl

    https://doi.org/10.1136/gutjnl-2017-315111

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      We read with interest the results of the pilot study in England, which was performed to establish the acceptability and diagnostic performance of screening with the faecal immunochemical test (FIT) over the guaiac faecal occult blood test (gFOBT).1 When comparing gFOBT to FIT, the uptake increased from 59.4% to 66.4%, positivity rate increased from 1.7% to 7.8% (at a cut-off level of 20 µg Hb/g faeces) and colorectal cancer (CRC) detection doubled. Moreover, this report showed that also with FIT cut-off levels above 20 µg Hb/g faeces, improved clinical outcomes can be achieved over gFOBT. However, for a screening programme to be effective, it is a prerequisite to detect cancers in an early stage. Thus far, information on stage distribution of screen-detected CRCs in a population-based FIT screening programme is lacking.

      In our study, we collected data on all CRCs detected in patients aged 60–75 years in the Netherlands in 2015 through the Netherlands Cancer Registry. In total, 9437 CRCs were diagnosed in 9301 patients: 3579 (38.5%) patients were diagnosed after a positive FIT in the CRC screening programme (screen-detected), 4506 (48.4%) patients were diagnosed due …

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