Colorectal cancer screening: why immunochemical fecal occult blood tests may be the best option

Kathy L Flitcroft, Les M Irwig, Stacy M Carter, Glenn P Salkeld, James A Gillespie, Kathy L Flitcroft, Les M Irwig, Stacy M Carter, Glenn P Salkeld, James A Gillespie

Abstract

Background: There are many test options available for colorectal cancer screening. The choice of test relates to the objectives of those offering or considering screening.

Discussion: While all screening programs aim to detect disease early in order to improve the length and/or quality of life for the individual, some organizations and individuals prefer screening tests that offer the opportunity for cancer prevention. Others favor maximizing participation or the opportunity for shared decision-making, including discussion of information on test quality and availability. We propose three additional objectives for screening: minimizing harms, optimizing economic efficiency and maximizing equity of access to screening.

Summary: Applying these objectives to colorectal cancer screening, we advocate the use of immunochemical FOBTs as the preferred screening strategy, as it satisfies all three of these important objectives.

References

    1. Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, Dash C, Giardiello FM, Glick S, Johnson D, Johnson CD, Levin TR, Pickhardt PJ, Rex DK, Smith RA, Thorson A, Winawer SJ. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American cancer society, the US multi-society task force on colorectal cancer, and the American college of radiology. Gastroenterology. 2008;134:1570–1595. doi: 10.1053/j.gastro.2008.02.002.
    1. S. Preventive Services Task Force. Screening for colorectal cancer: U.S preventive services task force recommendation statement. Ann Intern Med. 2008;149:627–637.
    1. Howard K, Salkeld G, Irwig L, Adelstein B-A. High participation rates are not necessary for cost-effective colorectal cancer screening. J Med Screen. 2005;12(2):96–102. doi: 10.1258/0969141053908276.
    1. Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM. American college of gastroenterology guidelines for colorectal cancer screening. Am J Gastroenterol. 2009;104:739–750. doi: 10.1038/ajg.2009.104.
    1. Entwistle VA, Carter SM, Trevena LJ, Flitcroft KL, Irwig LM, McCaffery K, Salkeld G. Communicating about screening: a proposed new direction. BMJ. 2008;337:789–791. doi: 10.1136/bmj.a789.
    1. Stefanek ME. Uninformed compliance or informed choice? A needed shift in our approach to cancer screening. J Natl Cancer Inst. 2011;103(24):1821–1826. doi: 10.1093/jnci/djr474.
    1. Wilson J, Jungner G. Principles and practice of screening for disease. Geneva: World Health Organization; 1968.
    1. Law M. Screening without evidence of efficacy. BMJ. 2004;328:301–302. doi: 10.1136/bmj.328.7435.301.
    1. Wald NJ. Screening: a step too far. A matter of concern. J Med Screen. 2007;14:163–164. doi: 10.1258/096914107782912040.
    1. The UK CRC Screening Pilot Evaluation Team. Evaluation of the UK colorectal cancer screening pilot. Edinburgh: UK CRC Screening Pilot Evaluation Team; 2003.
    1. Australian Government, Department of Health and Ageing. The Australian BowelCancer screening pilot program and beyond. Canberra: Final Evaluation Report; 2005.
    1. Tappenden P, Chilcott J, Eggington S, Patnick J, Sakai H, Karnon J. Option appraisal of population-based colorectal cancer screening programmes in England. Gut. 2007;56:677–684. doi: 10.1136/gut.2006.095109.
    1. Pignone MP, Flitcroft KL, Howard K, Trevena LJ, Salkeld GP, St John DJB. Costs and cost-effectiveness of full implementation of a biennial faecal occult blood test screening program for bowel cancer in Australia. Med J Aust. 2011;194(4):180–185.
    1. Atkin WS, Edwards R, Kralj-Hans I, Wooldrage K, Hart AR, Northover JM, Parkin DM, Wardle J, Duffy SW, Cuzick J. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet. 2010;375(9726):1624–1633. doi: 10.1016/S0140-6736(10)60551-X.
    1. NHS Bowel Cancer Screening Program. Introduction of flexible sigmoidoscopy screening. .
    1. Hewitson P, Glasziou PP, Irwig L, Towler B, Watson E. Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Cochrane Database Syst Rev. 2007;Jan 24(Issue 1):CD001216.
    1. Benson VS, Patnick J, Davies AK, Nadel MR, Smith RA, Atkin WS. on behalf of the International Colorectal Cancer Screening Network. Colorectal cancer screening: A comparison of 35 initiatives in 17 countries. Int J Cancer. 2008;122:1357–1367.
    1. Church TR. Screening for colorectal cancer - which strategy is best? J Natl Cancer Inst. 2011;103(17):1282–83. doi: 10.1093/jnci/djr300.
    1. Rabeneck L, Paszat LF, Hilsden RJ, Saskin R, Leddin D, Grunfeld E, Wai E, Goldwasser M, Sutradhar R, Stukal TA. Bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice. Gastroenterology. 2008;135:1899–18906. doi: 10.1053/j.gastro.2008.08.058.
    1. National Health and Medical Research Council. Guidelines for the prevention early detection and management of colorectal cancer. Canberra: Commonwealth of Australia; 1999.
    1. Launoy GD, Bertrand HJ, Berchi C, Talbourdet VY, Guizard VN, Bouvier VM, Caces ER. Evaluation of an immunochemical fecal occult blood test with automated reading in screening for colorectal cancer in a general average-risk population. Int J Cancer. 2005;115(3):493–496. doi: 10.1002/ijc.20921.
    1. Guittet L, Bouvier V, Mariotte N, Vallee JP, Arsène D, Boutreaux S, Tichet J, Launoy G. Comparison of a guaiac based and an immunochemical faecal occult blood test in screening for colorectal cancer in a general average risk population. Gut. 2007;56:210–214. doi: 10.1136/gut.2006.101428.
    1. Rozen P, Levi Z, Hazazi R, Waked A, Vilkin A, Maoz E, Birkenfeld S, Niv Y. Quantitative colonoscopic evaluation of relative efficiencies of an immunochemical faecal occult blood test and a sensitive guaiac test for detecting significant colorectal neoplasms. Aliment Pharmacol Ther. 2009;29:450–457. doi: 10.1111/j.1365-2036.2008.03898.x.
    1. Hol L, van Leerdam ME, van Bellegooijen M, van Vuuren AJ, van Dekken H, Reijerink JCIY, van der Togt ACM, Habbema JDF, Kuipers EJ. Screening for colorectal cancer: Randomized trial comparing guaiac-based and immunochemical faecal occult blood testing and flexible sigmoidoscopy. Gut. 2010;59:62–68. doi: 10.1136/gut.2009.177089.
    1. Duffy SW, Hill C, Estève J, Day NE. In: Quantitative methods for the evaluation of cancer screening. Duffy SW, Hill C, Estève J, editor. London: Edward Arnold Ltd; 2001. Introduction and brief history of cancer screening evaluation techniques; pp. 1–12.
    1. Appleyard M, Grimpen F, Spucches C, Si D, Thompson A. Participation in the national bowel cancer screening program and screening outcomes in Queensland [abstract] Gastroenterol Hepatol. 2011;26(s4):4.
    1. Ferlitsch M, Reinhart K, Pramhas S, Wiener C, Gal O, Bannert C, Hassler M, Kozibal K, Dunkler D, Trauner M, Weiss W. Sex-specific prevalence of adenomas, advanced adenomas, and colorectal cancer in individuals undergoing screening colonoscopy. JAMA. 2011;306(12):1352–1358. doi: 10.1001/jama.2011.1362.
    1. Flitcroft KL, St John DJB, Howard K, Carter SM, Pignone MP, Salkeld GP, Trevena LJ. A comparative case study of bowel cancer screening in the UK and Australia: evidence lost in translation. J Med Screen. 2011;18:193–203. doi: 10.1258/jms.2011.011066.
    1. Goodwin JS, Singh A, Reddy N, Riall TS, Kuo Y-F. Overuse of screening colonoscopy in the Medicare population. Arch Intern Med. 2011;171(15):1335-–1343. doi: 10.1001/archinternmed.2011.212.
    1. National Bowel Cancer Screening Program Quality Working Group. Improving colonoscopy services in Australia. Report from the national bowel cancer screening program quality working group. Canberra; Australian Government: Department of Health and Ageing; 2009.
    1. Adelstein B-A, Macaskill P, Chan SF, Katelaris PH, Irwig L. Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review. BMC Gastroenterol. 2011;11(65):10 pp.
    1. Adelstein B-A, Macaskill P, Turner RM, Katelaris PH, Irwig L. The value of age and medical history for predicting colorectal cancer and adenomas in people referred for colonoscopy. BMC Gastroenterol. 2011;11(97):10pp.
    1. Mandel JS, Church TR, Ederer F, Bond JH. Colorectal cancer mortality Effectiveness of biennial screening for fecal occult blood. J Natl Cancer Inst. 1999;91(5):434-–437. doi: 10.1093/jnci/91.5.434.
    1. Christou A, Katzenellenbogen J, Thompson SC. Australia's National bowel cancer screening program: does it work for indigenous Australians. BMC Pub Health. 2010;10(373):45pp.
    1. von Wagner C, Baio G, Raine R, Snowball J, Morris S, Atkin W, Obichere A, Handley G, Logan RF, Rainbow S, Smith S, Halloran S, Wardle J. Inequalities in participation in an organized national colorectal cancer screening programme: results from the first 2.6 million invitations in England. Int J Epidemiol. 2011;40(3):712–718. doi: 10.1093/ije/dyr008.
    1. Levin TR. Optimizing colorectal cancer screening by getting FIT right. Gastroenterology. 2011;141:1551–1555. doi: 10.1053/j.gastro.2011.09.021.

Source: PubMed

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