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Therapeutics
Faecal occult blood screening reduced the incidence of colorectal cancer

https://doi.org/10.1136/ebm.6.3.89

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    (2000) N Engl J Med 343, 1603. Mandel JS, Church TR, Bond JH, et al.. The effect of fecal occult-blood screening on the incidence of colorectal cancer.. Nov 30;. :. –7.
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 QUESTION: Does faecal occult blood screening reduce the incidence of colorectal cancer?

    Design

    Randomised {allocation concealed*}†, unblinded,* controlled trial with 18 years follow up.

    Setting

    Minnesota, USA.

    Participants

    46 551 participants who were 50–80 years of age (52% women) and did not have a previous diagnosis of colorectal cancer. Follow up for vital status was 91% at 18 years.

    Intervention

    Participants were allocated to annual screening (n=15 532), biennial screening (n=15 550), or usual care (n=15 363). For each screening, which was done from 1976–82 and from 1986–92, participants prepared 2 guaiac impregnated paper slides for each of 3 consecutive stools. The mean rate of compliance was 75% in the annual screening group and 78% in the biennial screening group. Participants with ≥1 positive slide had a …

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    Footnotes

    • Sources of funding: National Cancer Institute and Centers for Disease Control and Prevention.

    • For correspondence: Dr J S Mandel, Exponent, 149 Commonwealth Drive, Menlo Park, CA 94025, USA. Fax +1 650 688 1799.

    • ↵* See glossary.

    • ↵† Information provided by author.