Prevention of advanced colorectal cancer by screening using the immunochemical faecal occult blood test: a case-control study

• Published in: British journal of cancer Vol. 89; no. 1; pp. 23 - 28
• Main Authors: NAKAJIMA, M, SAITO, H, SOMA, Y, SOBUE, T, TANAKA, M, MUNAKATA, A
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 07.07.2003
• Subjects: Adult; Aged; Biological and medical sciences; Blood tests; Cancer research; Case-Control Studies; Clinical; Colorectal cancer; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - pathology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Immunochemistry; Internal medicine; Male; Mass Screening; Medical research; Medical sciences; Medical screening; Medicine; Middle Aged; Neoplasm Staging; Occult Blood; Prevention; Rectum; Risk Assessment; Sensitivity and Specificity; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Asia; Japan; Human; screening; Rectal disease; colorectal cancer; advanced cancer immunochemical test; Case control study; Malignant tumor; Medical screening; Immunochemistry; Blood; Colonic disease; Prevention; faecal occult blood; case-control study; Rectum; Digestive diseases; Intestinal disease; Advanced stage; Colon; Feces; Public health
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6601002

To evaluate colorectal cancer screening with faecal occult blood testing (FOBT) in terms of prevention of advanced cancers, we conducted a case-control study in the areas where an annual screening programme with immunochemical FOBT has been offered to all inhabitants aged 40 years or over. Cases were 357 consecutive patients in the study areas clinically diagnosed as having advanced colorectal cancer or a tumour invading the muscularis propriae or deeper, that is, T(2)-T(4) in TNM classification. Three controls were selected for each case matched by gender, age, residential area and exposure status to screening within 1 year before case diagnosis. The odds ratios (ORs) of developing advanced cancer were calculated using conditional logistic regression analyses. The OR for those screened within 3 years before the diagnosis vs those not screened was 0.54 (95% confidence interval (CI) 0.29-0.99). The ORs were lower for rectum than for colon (0.32-0.73 and 0.84-1.18 for rectum and colon, respectively). For those screened within the past 3 years, OR of developing advanced cancer in the rectum was 0.32 ( 95%CI: 0.12-0.84). A screening programme with immunochemical FOBT can be effective for prevention of advanced colorectal cancer. Risk reduction appears to be larger for rectal than for colon cancer. British Journal of Cancer (2003) 89, 23-28. doi:10.1038/sj.bjc.6601002 www.bjcancer.com