Flexible sigmoidoscopy following a positive faecal occult blood test within a bowel screening programme may reduce the detection of neoplasia

2013 ◽  
Vol 15 (11) ◽  
pp. 1375-1381 ◽  
Author(s):  
D. Mansouri ◽  
D. C. McMillan ◽  
C. S. D. Roxburgh ◽  
S. J. Moug ◽  
E. M. Crighton ◽  
...  
Keyword(s):  
Blood Test ◽  
Flexible Sigmoidoscopy ◽  
Screening Programme ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Occult Blood Test ◽  
Faecal Occult Blood ◽  
Faecal Occult

scholarly journals Changes in prevalence of faecal occult blood positivity over time

2019 ◽  
Vol 26 (4) ◽  
pp. 191-196 ◽  
Author(s):  
Anna Goulding ◽  
Gavin RC Clark ◽  
Annie S Anderson ◽  
Judith A Strachan ◽  
Callum G Fraser ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Positive Predictive Value ◽  
Blood Test ◽  
Screening Programme ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Occult Blood Test ◽  
Faecal Occult Blood ◽  
Faecal Occult ◽  
Over Time

Objectives Changes in the prevalence of faecal occult blood test positivity over time have not been previously reported, but could have important implications. This study examined the positivity of the initial guaiac faecal occult blood test, a surrogate marker for colorectal bleeding, in participants aged 50 in a national bowel screening programme. Methods Data from the Scottish Bowel Screening Programme were used to study the initial positivity of the guaiac faecal occult blood test between 2007 and 2017. Positive predictive values of the testing process for colorectal cancer and adenoma were assessed over the same time period. Results Across Scotland, the initial guaiac faecal occult blood test positivity increased from 4.1 to 10.8%. In NHS Grampian and NHS Fife, two of the three NHS Boards which began roll-out of screening in 2007, it increased from 4.0 to 10.9%. In the Scottish Bowel Screening Programme, the positive predictive value declined from 11.0 to 6.6% for colorectal cancer and increased from 31.6 to 39.8% for adenoma. Conclusions In the Scottish programme over a decade, initial guaiac faecal occult blood test positivity increased in participants aged 50. This may be associated with changes in lifestyle and might have implications for screening clinical outcomes, including positive predictive value.

scholarly journals Randomized controlled trial: Flexible sigmoidoscopy as an adjunct to faecal occult blood testing in population screening

2019 ◽  
Vol 27 (2) ◽  
pp. 59-67
Author(s):  
Robert JC Steele ◽  
Francis A Carey ◽  
Greig Stanners ◽  
Jaroslaw Lang ◽  
Jess Brand ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Blood Test ◽  
Detection Rate ◽  
Flexible Sigmoidoscopy ◽  
Controlled Trial ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Occult Blood Test ◽  
Faecal Occult Blood ◽  
Faecal Occult

Objectives Flexible sigmoidoscopy screening at around age 60 can reduce colorectal cancer incidence. Insufficient evidence exists on flexible sigmoidoscopy at age 60 in a population being offered biennial faecal occult blood test screening from age 50. This randomized controlled trial assessed if flexible sigmoidoscopy would be an effective adjunct to faecal occult blood test. Methods In the Scottish Bowel Screening Programme between June 2014 and December 2015, 51,769 individuals were randomized to be offered flexible sigmoidoscopy instead of faecal occult blood test at age 60 or to continue faecal occult blood test. Those not accepting flexible sigmoidoscopy and those with normal flexible sigmoidoscopy were offered faecal occult blood test. All with flexible sigmoidoscopy-detected neoplasia or a positive faecal occult blood test result were offered colonoscopy. Results Overall flexible sigmoidoscopy uptake was 17.8%, higher in men than women, and decreased with increasing deprivation (25.7% in the least to 9.2% in the most deprived quintile). In those who underwent flexible sigmoidoscopy, detection rate for colorectal cancer was 0.13%, for adenoma 7.27%, and for total neoplasia 7.40%. In those who underwent colonoscopy after a positive flexible sigmoidoscopy, detection rate for colorectal cancer was 0.28%, adenoma 8.66%, and total neoplasia 8.83%. On an intention to screen basis, there was no difference in colorectal cancer detection rate between the study and control groups. Adenoma and total neoplasia detection rate were significantly higher in the study group, with odds ratios of 5.95 (95%CI: 4.69–7.56) and 5.10 (95%CI: 4.09–6.35), respectively. Conclusions In a single screening round at age 60, there was low uptake and neoplasia detection rate. Flexible sigmoidoscopy detected significantly more neoplasia than faecal occult blood test alone.

scholarly journals Effect of once-only flexible sigmoidoscopy screening on the outcomes of subsequent faecal occult blood test screening

2018 ◽  
Vol 26 (1) ◽  
pp. 11-18 ◽  
Author(s):  
Jeremy P Brown ◽  
Kate Wooldrage ◽  
Ines Kralj-Hans ◽  
Suzanne Wright ◽  
Amanda J Cross ◽  
...  
Keyword(s):  
Blood Test ◽  
Flexible Sigmoidoscopy ◽  
Colorectal Neoplasia ◽  
Intervention Group ◽  
Occult Blood ◽  
Faecal Occult Blood Test ◽  
Control Group ◽  
Occult Blood Test ◽  
Faecal Occult Blood ◽  
Faecal Occult

Objective To investigate the outcomes of biennial guaiac faecal occult blood test (gFOBT) screening after once-only flexible sigmoidoscopy (FS) screening. Methods Between 1994 and 1999, as part of the UK FS Screening Trial (UKFSST), adults aged 55–64 were randomly allocated to an intervention group (offered FS screening) or a control group (not contacted). From 2006, a subset of UKFSST participants (20,895/44,041 intervention group; 41,497/87,149 control group) were invited to biennial gFOBT screening by the English Bowel Cancer Screening Programme. We analysed gFOBT uptake, test positivity, yield of colorectal cancer (CRC), and positive predictive value (PPV) for CRC, advanced adenomas (AAs), and advanced colorectal neoplasia (ACN: AA/CRC). Results Uptake of gFOBT at first invitation was 1.9% lower (65.7% vs. 67.6%, p < 0.01) among intervention versus control group participants. Positivity was 0.4% lower (2.0% vs. 2.4%, p < 0.01) and CRC yield was 0.08% lower (0.19% vs. 0.27%, p = 0.14). PPVs were also lower in the intervention versus control group, at 10.3% vs. 12.3% ( p = 0.44) for CRC, 22.7% vs. 31.4% ( p < 0.01) for AA, and 33.0% vs. 43.7% ( p < 0.01) for ACN. Among those who refused FS ( n = 5532), gFOBT uptake at first invitation was 47.7%, CRC yield was 0.25%, and PPV for ACN was 46.2%. Among FS attenders ( n = 15,363), uptake was 72.2%, CRC yield was 0.18%, and PPV for ACN was 27.9%. Conclusions Uptake, positivity and PPV of gFOBT screening were reduced following prior offer of FS screening. However, a quarter of FS screened participants receiving a diagnostic examination after positive gFOBT were diagnosed with ACN.

Sign in / Sign up

Export Citation Format

Share Document