Coverage and performance of colorectal cancer screening with the faecal occult blood test in Finland
Coverage and performance of colorectal cancer screening with the faecal occult blood test in Finland
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DOI：
10.1258/jms.2010.010036
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发表时间：
2011-01-01
影响因子：
2.9
通讯作者：
Hakama, Matti
中科院分区：
文献类型：
--
作者：
Malila, Nea;Palva, Tiina;Hakama, Matti
在随机筛选试验中，使用粪便隐血（FOB）检测反复筛查结直肠癌的死亡率已被证明可以降低。本报告介绍了芬兰普通人群中有组织筛查的覆盖率和效果。方法2004-2007年，60-69岁的人群随机分为两年一次的筛查组和对照组。筛选试验为以愈创木为基础的FOB试验（血隐性(R)），并限制饮食，连续6个样品进行3张试验卡。检测结果呈阳性者转作全面结肠镜检查。该方案于2004年启动，随后扩大到各地区和各年龄组。结果2007年，该方案覆盖了三分之一的目标人口，邀请了74,592人进行筛查，其中26,866人参加了第二轮筛查。在第一轮和第二轮中，男性分别占62%和68%，女性占77%和80%。从第一轮到第二轮，检测阳性的比例从2.4%上升到2.9%，癌症的阳性预测值从7.5%下降到4.3%。到2007年，芬兰有组织的结直肠癌筛查覆盖了三分之一的目标人群。以应答率衡量的筛查的实施是成功的，符合公共卫生方案的标准，但在阳性预测值方面的表现需要监测。
Introduction Mortality from colorectal cancer has been shown to decrease by repeated screening using faecal occult blood (FOB) testing in randomized screening trials. This report presents coverage and performance of organized screening among the general population in Finland.Methods In 2004-2007, people aged 60-69 years were randomized into biennial screening and control arms. The screening test was a guaiac-based FOB test (Hemoccult (R)) with dietary restriction and three test cards for six consecutive samples. Test positives were referred for full colonoscopy. The programme was launched in 2004 and subsequently it expanded over regions and age-cohorts.Results In 2007, the programme covered one-third of the target population and 74,592 people had been invited for screening, of them 26,866 for the second round. Uptakes for the first and second rounds, respectively, were 62% and 68% in men and 77% and 80% in women. The proportion of test positives increased from 2.4% to 2.9% from the first to the second round and the positive predictive value for cancers decreased from 7.5% to 4.3%.Conclusions By 2007, organized colorectal cancer screening covered one-third of the target population in Finland. Implementation of screening measured with response rate was successful and met the criteria for a public health programme, but performance in terms of positive predictive value needs monitoring.