Dr Bernard Denis and colleagues from France assessed both feasibility and short term outcomes of a population based colorectal cancer screening program using a biennial guaiac based fecal occult blood test.
The team invited 182,981 residents aged 50 to 74 to take part in a screening program using a non-rehydrated guaiac based fecal occult blood test.
|The positive predictive value was 43% for neoplasia|
The guaiac based fecal occult blood tests were first provided by general practitioners and then directly mailed to individuals who failed to comply after 2 invitations.
The researchers excluded 19,274 people from guaiac based fecal occult blood test screening.
The team noted that 90,706 completed a guaiac based fecal occult blood test, so that the participation rate was 55% of those eligible.
The research team reported that 77% of the completed guaiac based fecal occult blood tests were provided by general practitioners, and 16% by direct mailing.
The team found the guaiac based fecal occult blood test positivity rate was 3%.
The positive predictive value was 43% for neoplasia, 24% for advanced adenoma, and 8% for cancer.
The number of normal colonoscopic procedures needed to be performed for each colonoscopy in detecting an advanced neoplasia was 1.8.
The team noted that this was lower in men than in women, and decreased with age.
The research team observed that detection rates for neoplasia and cancer were 13 and 2 per 1000 people screened, respectively.
The team detected 206 adenocarcinomas, of which 48% were stage I and 24% were stage II.
The direct cost was estimated at 29 per screened person and 13,466 per cancer detected.
Dr Denis' team concluded, "Participation and diagnostic yield of controlled trials of guaiac based fecal occult blood test screening are reproducible in the real world at an acceptable cost through an organised population based programme involving general practitioners."