TY - JOUR
T1 - Comparing Attendance and Detection Rate of Colonoscopy With Sigmoidoscopy and FIT for Colorectal Cancer Screening
AU - Segnan, Nereo
AU - Senore, Carlo
AU - Andreoni, Bruno
AU - Azzoni, Alberto
AU - Bisanti, Luigi
AU - Cardelli, Alessandro
AU - Castiglione, Guido
AU - Crosta, Cristiano
AU - Ederle, Andrea
AU - Fantin, Alberto
AU - Ferrari, Arnaldo
AU - Fracchia, Mario
AU - Ferrero, Franco
AU - Gasperoni, Stefano
AU - Recchia, Serafino
AU - Risio, Mauro
AU - Rubeca, Tiziana
AU - Saracco, Giorgio
AU - Zappa, Marco
PY - 2007/6
Y1 - 2007/6
N2 - Background & Aims: We conducted a study to estimate population coverage and detection rate (DR) achievable through different strategies of colorectal cancer (CRC) screening. Methods: A population-based multicenter randomized trial comparing 3 strategies was used: (1) biennial immunologic fecal occult blood test (FIT), (2) "once only" sigmoidoscopy (FS), and (3) "once only" colonoscopy (TC). A random sample of men and women, aged 55 to 64 years, was drawn from general practitioners' (GP) rosters. Eligible subjects, randomized within GP, were mailed a personal invitation. Nonresponders in groups 2 and 3 were invited again at 12 and 24 months. Screenees with "high-risk" distal polyps (villous component >20%, high-grade dysplasia, CRC, size ≥10 mm, >2 adenomas) at FS, or with positive FIT, were referred for TC. Results: The attendance rate was 32.3% (1965/6075) for FIT, 32.3% (1944/6018) for FS, 26.5% (1597/6021) for TC. FIT detected 2 patients with CRC (0.1%) and 21 with an advanced adenoma (1.1%). The corresponding figures were as follows: 12 (0.6%) and 86 (4.5%) patients, respectively, for FS; 13 (0.8%) and 100 (6.3%) patients, respectively, for TC. To detect 1 advanced neoplasm, it would be necessary to invite 264 people with FIT, 60 with FS, 53 with TC. FS would have detected 27.3% of the proximal advanced neoplasms detected at TC. Assuming the same participation rate at TC as at FS, 48 TCs would be necessary to detect 1 additional advanced neoplasm missed by FS. Conclusions: When participants are offered 1 screening test, participation is lower in a TC than in an FS program. However, DR of advanced neoplasia is higher with TC.
AB - Background & Aims: We conducted a study to estimate population coverage and detection rate (DR) achievable through different strategies of colorectal cancer (CRC) screening. Methods: A population-based multicenter randomized trial comparing 3 strategies was used: (1) biennial immunologic fecal occult blood test (FIT), (2) "once only" sigmoidoscopy (FS), and (3) "once only" colonoscopy (TC). A random sample of men and women, aged 55 to 64 years, was drawn from general practitioners' (GP) rosters. Eligible subjects, randomized within GP, were mailed a personal invitation. Nonresponders in groups 2 and 3 were invited again at 12 and 24 months. Screenees with "high-risk" distal polyps (villous component >20%, high-grade dysplasia, CRC, size ≥10 mm, >2 adenomas) at FS, or with positive FIT, were referred for TC. Results: The attendance rate was 32.3% (1965/6075) for FIT, 32.3% (1944/6018) for FS, 26.5% (1597/6021) for TC. FIT detected 2 patients with CRC (0.1%) and 21 with an advanced adenoma (1.1%). The corresponding figures were as follows: 12 (0.6%) and 86 (4.5%) patients, respectively, for FS; 13 (0.8%) and 100 (6.3%) patients, respectively, for TC. To detect 1 advanced neoplasm, it would be necessary to invite 264 people with FIT, 60 with FS, 53 with TC. FS would have detected 27.3% of the proximal advanced neoplasms detected at TC. Assuming the same participation rate at TC as at FS, 48 TCs would be necessary to detect 1 additional advanced neoplasm missed by FS. Conclusions: When participants are offered 1 screening test, participation is lower in a TC than in an FS program. However, DR of advanced neoplasia is higher with TC.
UR - http://www.scopus.com/inward/record.url?scp=34250006056&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34250006056&partnerID=8YFLogxK
U2 - 10.1053/j.gastro.2007.03.030
DO - 10.1053/j.gastro.2007.03.030
M3 - Article
C2 - 17570205
AN - SCOPUS:34250006056
VL - 132
SP - 2304
EP - 2312
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 7
ER -