Uptake of faecal immunochemical test screening among nonparticipants in a flexible sigmoidoscopy screening programme

• Published in: International journal of cancer Vol. 130; no. 9; pp. 2096 - 2102
• Main Authors: Hol, Lieke, Kuipers, Ernst J., van Ballegooijen, Marjolein, van Vuuren, Anneke J., Reijerink, Jaqueline C.I.Y., Habbema, Dik J.F., van Leerdam, Monique E.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.05.2012; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Adenoma - diagnosis; Adenoma - epidemiology; Adenoma - pathology; Aged; Biological and medical sciences; Cancer; colorectal cancer; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - pathology; Confidence intervals; faecal immunochemical test; Feces - chemistry; Female; flexible sigmoidoscopy; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Immunochemistry - methods; Male; Mass Screening; Medical research; Medical sciences; Medical screening; Middle Aged; Neoplasm Staging; Netherlands; noncompliance; Refusal to Participate; screening; Sigmoidoscopy - methods; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Netherlands; screening; Rectal disease; Sigmoidoscopy; Digestive system; Gut; Colorectal cancer; Malignant tumor; Medical screening; noncompliance; flexible sigmoidoscopy; Colonic disease; Cancerology; Flexible; Digestive diseases; Intestinal disease; Endoscopy; Colon; Feces; faecal immunochemical test; Cancer
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.26260

Screening programmes based on single modality testing may prevent individuals with a preference for a different test from participating. We conducted a population‐based trial to determine whether nonparticipants in flexible sigmoidoscopy (FS) screening were willing to attend faecal immunochemical test (FIT) screening. In total, 8,407 subjects were invited in a primary FS screening programme. Invitees did not know at the time of FS invitation that nonparticipants would be offered FIT screening. A total of 4,407 nonparticipants of FS screening were invited for FIT screening (cut‐off 50 ng haemoglobin/ml). The participation rate to FS screening was 31% [95% confidence interval (CI): 30–32%]. Among the FS nonparticipants 25% (CI: 24–26%) did attended FIT screening. The participation rate of the two‐stage recruitment for FS and FIT screening was 45% (CI: 44–46%). FIT screenees were older (p = 0.02), more often women (p < 0.001) and had a lower social economic status (p = 0.01) than FS screenees. The detection rate (DR) for advanced adenoma was 3.5% (CI: 2.5–4.8%), and for colorectal cancer (CRC) it was 0.3% (CI: 0.1–0.8%) among participants to FIT screening. The DR of the two‐stage recruitment was 6.1% (n = 202) for an advanced adenoma and 0.5% (n = 16) for a CRC. In conclusion, offering FIT screening to nonparticipants in a FS screening programme increases the overall participation rate considerably, as a quarter of nonparticipants of FS screening was willing to attend FIT screening. The participation rate remains lower for primary FIT screening in the same population (62%). Women in the target population were more likely to refuse FS than FIT screening. Countries introducing FS screening should be aware of these preferences.