Approximately 30% of participants in a randomized trial of various colorectal cancer screening strategies chose to participate in screening regardless of whether they were offered an immunochemical fecal occult blood test (FOBT), sigmoidoscopy, or a choice of the two methods, according to a new study.

It is generally accepted that colorectal cancer screening reduces the incidence of and mortality from the disease. Strategies for population-based screening programs are being evaluated in several European countries, including Italy. Comparative data about rates of detection and participation and economic costs are needed to estimate the effectiveness of the various programs.

To compare participation and detection rates achievable through different strategies for invitation to colorectal cancer screening, Nereo Segnan, M.D., of the Centro Prevenzione Oncologica Regione Piemonte and Azienda Sanitaria Ospedaliera S Giovanni Battista in Torino, Italy, and colleagues conducted a multicenter, randomized trial of Italians ages 55 to 64 who were at average risk for colorectal cancer. The subjects were randomly assigned to one of five different screening options: a biennial FOBT delivered by mail; a biennial FOBT delivered through clinical practice; a choice of FOBT or sigmoidoscopy; sigmoidoscopy; or sigmoidoscopy followed by biennial FOBT.

The participation rates were similar in all five groups; approximately 27% to 30% of people chose to be screened. However, sigmoidoscopy detected approximately three times as many advanced neoplasias as did FOBT. In addition, the participation rate in the sigmoidoscopy groups was higher in men than in women and lower among subjects ages 60 to 64 than among subjects ages 55 to 59, showing different preferences in these groups.

In an editorial, Timothy R. Church, Ph.D., of the University of Minnesota Scho
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Contact: Sarah L. Zielinski
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301-841-1287
Journal of the National Cancer Institute
1-Mar-2005