Screening for colorectal cancer detects unrecognized disease

Nov 21, 2008

Screening for colorectal cancer detects four out of ten cancers and should be carefully designed to be more effective, according to a study published today on bmj.com.

About one in 20 people in the UK develop bowel cancer during their lifetime. It is the third most common cancer in the UK and the second leading cause of cancer deaths in Europe and the US.

Previous screening trials have show that faecal occult blood testing can reduce the risk of dying by about 16%. More than 50 countries have introduced screening programmes, but their effectiveness in a public health setting is not clear.

Dr Nea Malila and colleagues from the Finnish Cancer Registry examined whether Finland's national colorectal cancer screening programme could detect unrecognised disease. They studied 106 000 people aged 60󈞬 to test how sensitive screening was in identifying unrecognised disease at three levels—the faecal occult blood test (test to detect small traces of blood in faeces that may indicate disease at an early stage), screening episode, and the national screening programme.

A national screening programme for colorectal cancer began in Finland in 2004 as a public health policy in 22 volunteer municipalities and grew to 161 municipalities by 2006.

Nationally it was decided to split the 106 000 people into two groups—a screening group which received faecal occult blood tests kits by mail and a control group which received the routine health services available in the country.

Anyone whose test indicated blood was contacted so a full colonoscopy could take place.

The researchers found that the sensitivity (accuracy) of the test was 55% when considering cancers that developed after positive tests. The sensitivity from screening episodes was 51% and sensitivity was 38% for the national screening programme.

Roughly, four out of ten colorectal cancers were detected thanks to the organised colorectal cancer screening programme and the researchers concluded that the sensitivity of the Finnish programme was "adequate if relatively low".

The study also presents a model of how to implement a new programme using the principles of experimental design to provide good evidence on effectiveness.

The researchers say: "The sensitivity of the Finnish screening programme for colorectal cancer at the first round was adequate even if relatively low. Programme sensitivity in Finland was sufficient to justify continuation of the programme."

In an accompanying editorial, Joan Austoker and Paul Hewitson from the University of Oxford, say that in addition to programme sensitivity there are other important factors that should be taken into consideration when evaluating a cancer screening programme.

Source: British Medical Journal

Explore further: New family of small RNAs boosts cell proliferation in cancer

Related Stories

Can pollution help trees fight infection?

4 hours ago

Trees that can tolerate soil pollution are also better at defending themselves against pests and pathogens. "It looks like the very act of tolerating chemical pollution may give trees an advantage from biological ...

Most internet anonymity software leaks users' details

4 hours ago

Virtual Private Networks (VPNs) are legal and increasingly popular for individuals wanting to circumvent censorship, avoid mass surveillance or access geographically limited services like Netflix and BBC ...

Improving rice flour to aid food poverty

4 hours ago

A new, high-quality rice flour could help towards aiding global food poverty. "This rice flour serves not only as an alternative to wheat flour for those with wheat intolerance, but could also help to overcome ...

In the UK, bPay offers fob, band or sticker options

6 hours ago

Method of payment: "Cash or credit?" The two options sound so yesterday. In the UK, technology support in banking offers a new type of menu—band on the wrist, fob or sticker. The three new devices from ...

WikiLeaks says NSA spied on French business

6 hours ago

WikiLeaks has released documents that it says show that the U.S. National Security Agency eavesdropped on France's top finance officials and high-stakes French export bids over a decade in what the group called targeted economic ...

Recommended for you

Researchers confirm gene p73's role in tumor growth

12 hours ago

A team of researchers at National Cancer Centre Singapore (NCCS) and Singapore General Hospital (SGH) has determined dual functionality gene p73, in both the promotion and suppression in tumour growth. The NCCS team also ...

Researchers define unique group of high-risk lymphoma patients

15 hours ago

The goal for many cancer patients is to reach the five-year, disease-free mark, but new research from UR Medicine's Wilmot Cancer Institute suggests that two years might be a more practical survival goal for people with follicular ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.