Several studies have shown that screening for colorectal cancer by fecal occult blood tests (FOBTs) can reduce mortality.
In this study, doctors from France assessed whether this benefit could be obtained in a country with high performance in the diagnosis and management of colorectal cancer.
The team randomized small-sized geographic areas in France to either FOBT screening or no screening. Six screening rounds were performed.
The study included 91,199 individuals aged 45 to 74 years.
The FOBT was performed without diet restriction and was sent to a central analysis center and processed without rehydration.
|Mortality was significantly lower in the screened population.|
Screening group participants who had a positive test result were offered a full colonoscopy.
The doctors followed the entire population for 11 years after study entry.
They found that the acceptability of the test was 53% at the first screening round. Acceptability varied between 54% and 58% in the successive rounds.
The team determined that positivity rates were 2.1% initially, and 1.4% on average in the successive rounds.
They established that colorectal cancer mortality was significantly lower in the screening population compared with the control population.
Furthermore, this reduction in colorectal cancer mortality was more pronounced in those who participated at least once.
Dr Jean Faivre and colleagues concluded, “Biennial screening by FOBTs can reduce colorectal cancer mortality regardless of the quality of the health system and support attempts to introduce large-scale screening programs into the general population”.