Colorectal cancer screening: strategies to select populations with moderate risk for disease

Rev Esp Enferm Dig. 2009 Dec;101(12):855-60. doi: 10.4321/s1130-01082009001200005.

Abstract

Objective: to analyse the association between rectal bleeding or a family history of colorectal cancer (CRC) and the results obtained in two rounds of a CRC screening pilot programme performed in L Hospitalet, Barcelona, Spain.

Subjects: males and females (50-69 years) were the target population. Together with the invitation letter, they received a questionnaire in which they were asked about rectal bleeding, family history of CRC and related neoplasms. The screening test was a guaiac-based faecal occult blood test (FOBT), and colonoscopy for positive tests.

Results: 25,829 FOBT were performed in 18,405 individuals. Information on rectal bleeding and a family history of CRC were obtained for 9,849 and 9,865 cases, respectively. Male sex (OR = 1.32), 60-69 years of age (OR = 1.48), rectal bleeding (OR = 1.84) and history of CRC (OR = 1.54) were independent predictors of positive FOBT. With regard to colonoscopy, a greater risk of diagnosing advanced neoplasm was observed among men (OR = 2.47) and subjects with a family history of CRC (OR = 1.98).

Conclusions: CRC screening programmes must have instruments that make it possible to select the candidate population and the possibility of offering a study suited to the risk of individuals who are not susceptible to population screening by means of FOBT.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Colorectal Neoplasms / epidemiology*
  • Colorectal Neoplasms / genetics
  • Data Interpretation, Statistical
  • Female
  • Hemorrhage
  • Humans
  • Male
  • Mass Screening*
  • Occult Blood
  • Pilot Projects
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Spain / epidemiology