Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom
Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom
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DOI：
10.1136/bmj.38153.491887.7c
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发表时间：
2004-07-17
影响因子：
105.7
通讯作者：
Steele, RJC
中科院分区：
文献类型：
--
作者：
Steele, RJC
ObjectiveTo assess the reliability of introducing into the United Kingdom's NHS a national screening program for colorectal cancer based on faecal occult blood testing.Design Demonstration pilot.Setting Two English health authorities and three Scottish health boards.Participants People aged 50-69 years.Results 478 250 residents of the pilot areas were invited to take part in the screening program.摄取率（可获得最终粪便潜血试验结果的比例）为56.8%（n = 271646）。阳性检测结果的总体比率为1.9%，每1000名接受筛查的人中发现癌症的比率为1.62。这两个值在苏格兰高于英格兰，男性高于女性，并随着年龄的增长而增加。肿瘤的阳性预测值为10.9%，腺瘤的阳性预测值为35.0%。通过筛查发现552例癌症; 92例（16.6%）为息肉癌。48%的所有屏幕检测到的癌症杜克斯的阶段A，和1%的转移在诊断时。结论通过测试粪便潜血筛查结直肠癌是可行的背景下，英国的NHS。筛查应导致提供筛查的人群中结直肠癌死亡的减少。
Objectives To assess the feasibility of introducing into the United Kingdom's NHS a national screening programme for colorectal cancer based on faecal occult blood testing.Design Demonstration pilot.Setting Two English health authorities and three Scottish health boards.Participants People aged 50-69 years.Results 478 250 residents of the pilot areas were invited to take part in the screening programme. Uptake (the proportion for whom a final faecal occult blood test result was available) was 56.8% (n = 271646). The overall rate of a positive test result was 1.9% and the rate for detecting cancer was 1.62 per 1000 people screened. Both these values were higher in Scotland than in England, were higher in men than in women, and increased with age. The positive predictive value was 10.9% for cancer and 35.0% for adenoma. 552 cancers were detected by screening; 92 (16.6%) were polyp cancers. 48% of all screen detected cancers were Dukes's stage A, and 1% had metastasised at the time of diagnosis.Conclusions Screening for colorectal cancer by testing for faecal occult blood is feasible within the context of the United Kingdom's NHS. Screening should lead to a reduction in deaths from colorectal cancer in the population offered screening.