A comparative study of faecal occult blood kits in a colorectal cancer screening program in a cohort of healthy construction workers
- 114 Downloads
The incidence of colorectal cancer (CRC) has been increasing. We evaluated uptake rates and outcomes of faecal immunochemical test (FIT) and Guaiac test (gFOBT) kits as part of a two-step CRC screening.
A 3-year CRC screening program for a defined population of construction workers was conducted. Those satisfying the inclusion criteria were provided with gFOBT or FIT kits. Individuals testing positive were invited for a colonoscopy.
A total of 909 faecal testing kits were distributed. Age range was 53–60 years. Compliance rate was higher for FIT (58.3%) as compared to gFOBT (46.7%) (p = 0.0006). FIT detected adenomatous polyps and CRC in 37.5 and 25%, respectively, whereas; gFOBT detected 23.5 and 18%. Colonoscopies were normal in 53 and 25% tested positive by gFOBT and FIT, respectively (p = 0.016).
The FIT was more cost-effective when compared with gFOBT with higher return rate, sensitivity and specificity. A comparative study of faecal occult blood kits in a CRC screening program in a healthy cohort of construction workers.
KeywordsColorectal cancer (CRC) Screening FIT (faecal immunochemical testing) gFOBT (gauaic faecal occult blood test) Adenomas Uptake rates Outcomes
The authors would like to acknowledge the Meath foundation and the Irish Construction Workers Health Trust for their support. We would like to thank all the staff at the Endoscopy Unit and the histopathology department in our university hospital.
Conflict of interest
- 5.Hofstad B (2003) Chapter 32: colon polyps: prevalence rates, incidence rates and growth rates. In: Wayne J, Rex D, Williams C (eds) Colonoscopy: principles and practice. Blackwell, Oxford, pp 358–376Google Scholar
- 15.Construction Workers Health Trust, Pattern of ill- health in Irish construction workers http://www.cwht.ie/screening-model.asp. April 2008
- 27.Young GP, St John DJ, Winawer SJ, Rozen P (2002) Choice of fecal occult blood tests for colorectal cancer screening: recommendations based on performance characteristics in population studies: a WHO (World Health Organization) and OMED (World Organization for Digestive Endoscopy) report. Am J Gastroenterol 97:2499–2507PubMedGoogle Scholar
- 30.UK Colorectal Cancer Screening Pilot Group (2004) Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom. BMJ 329:133 (Epub July 5)Google Scholar
- 31.Ciatto S; Martinelli F; Castiglione G et al. (2007) Association of FOBT-assessed faecal Hb content with colonic lesions detected in the Florence screening programme. Br J Cancer 96(2):218–221 (Epub 9 Jan 2007)Google Scholar
- 36.Bowel Cancer Screening Pilot Monitoring and Evaluation Steering Committee (2005) The Australian bowel cancer screening pilot and beyond: final evaluation report. Screening Monograph No. 6/2005. Bowel Cancer Screening Pilot Monitoring and Evaluation Steering Committee, CanberraGoogle Scholar
- 37.Place des tests immunologiques de recherche de sang occulte dans les selles (iFOBT) dans le programme de dépistage organisé du cancer colorectal en France (Dec 2008). Haute Autorité de Santé, France. http://www.has-sante.fr/. Accessed 1 Feb 2009