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. 2012 Jul 10;107(2):255-9.
doi: 10.1038/bjc.2012.277. Epub 2012 Jun 26.

The impact of population-based faecal occult blood test screening on colorectal cancer mortality: a matched cohort study

G Libby  1 , D H Brewster, P L McClements, F A Carey, R J Black, J Birrell, C G Fraser, R J C Steele
Affiliations

The impact of population-based faecal occult blood test screening on colorectal cancer mortality: a matched cohort study

G Libby et al. Br J Cancer. .

Abstract

Background: Randomised trials show reduced colorectal cancer (CRC) mortality with faecal occult blood testing (FOBT). This outcome is now examined in a routine, population-based, screening programme.

Methods: Three biennial rounds of the UK CRC screening pilot were completed in Scotland (2000-2007) before the roll out of a national programme. All residents (50-69 years) in the three pilot Health Boards were invited for screening. They received a FOBT test by post to complete at home and return for analysis. Positive tests were followed up with colonoscopy. Controls, selected from non-pilot Health Boards, were matched by age, gender, and deprivation and assigned the invitation date of matched invitee. Follow-up was from invitation date to 31 December 2009 or date of death if earlier.

Results: There were 379 655 people in each group (median age 55.6 years, 51.6% male). Participation was 60.6%. There were 961 (0.25%) CRC deaths in invitees, 1056 (0.28%) in controls, rate ratio (RR) 0.90 (95% confidence interval (CI) 0.83-0.99) overall and 0.73 (95% CI 0.65-0.82) for participants. Non-participants had increased CRC mortality compared with controls, RR 1.21 (95% CI 1.06-1.38).

Conclusion: There was a 10% relative reduction in CRC mortality in a routine screening programme, rising to 27% in participants.

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Figures

Figure 1
Figure 1
Number of all cause deaths in invited for screening and control groups.
Figure 2
Figure 2
Derivation of study population.
Figure 3
Figure 3
Cumulative mortality from colorectal cancer. Rate and 95% CI (Nelson–Aalen estimates).
Figure 4
Figure 4
Cumulative mortality from colorectal cancer by participation (Nelson–Aalen estimates).
See this image and copyright information in PMC

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