A Comparative Study on the Efficacy of a Mass Screening Program for Colorectal Cancer — Comparison Between Cancer Cases Detected by Mass Screening and by Outpatient Clinics

Abstract

The present study was carried out to investigate the efficacy of colorectal screening through a comparison of the characteristics of the cancer cases detected by screening programs and by outpatient clinics. A total of 78 cases with colorectal cancer diagnosed by screening programs using fecal occult blood test in Nagano Prefecture, Japan, was collected as the index group and the same cases (one matched cases) diagnosed through outpatient clinics served as the control group for the present study. A comparison of various factors, such as tumor site, Dukes' stage, histological type, and survival rate, was made between the index and control groups. No differences were noted in tumor site and histological type between the two groups examined. The proportion of early cancer and the survival rate, however, were significantly higher in the index group than in the control group (p < 0.01). These results suggest that colorectal screening is an efficient preventive measure. Asia Pac J Public Health1994;7(3):159-64.

Keywords

Colorectal cancer Dukes' stage fecal occult blood test efficacy Japan outpatient clinics screening for colorectal cancer survival rate

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References

1. Nakama H . Colorectal mass survey using fecal occult blood tests in a rural area. J Gastroenterol Mass Survey (in Japanese) 1990; 88: 80–2.

2. Selby JV , Friedman CD , Quesenberry CP Jr , et al. Effect of fecal occult blood testing on mortality from colorectal cancer. Ann Int Med 1993; 118: 1–6.

3. Chamberlain J , Day N , Hakama M , et al. UICC workshop of the project on evaluation of screening programmers for gastrointestinal cancer. Int J Cancer 1986; 37: 329–38.

4. Hisamichi S , Doi H , Iwasaki M , et al. Survey of mass screening for gastrointestinal cancer in Japan, 1990. J Gastroenterol Mass Survey (in Japanese) 1991; 92: 150–168.

5. Moss SM . Case-control studies of screening. Int J Epidemiol 1991; 20: 1–6.

6. Oshima A , Hirata H , Ubukata T , et al. Evaluation of a mass screening program for stomach cancer with a case-control study design. Int J Cancer 1986; 38: 829–33.

7. Hardcastle JD , Chamberlain J , Sheffied J , et al. Randomised controlled trial of faecal occult blood screening for colorectal cancer. Lancet 1989; 1: 1160–4.

8. Knight K , Fielding JE , Batlista R . Occult blood screening for colorectal cancer. JAMA 1989; 21: 586–93.

9. Kronborg O : Population screening for colorectal cancer, the goals and means. Ann Med 1991; 23: 373–9.

10.

10. Kronborg O , Fenger C , Olsen J , et al. Repeated screening for colorectal cancer with fecal occult blood test. A prospective randomized study at Funen in Denmark. Scand J Gastroenterol 1989; 24: 599–606.

11.

11. Fujita M , Sugiyama R , Kumanishi Y , et al. Comparison between clini-copathological features and survival of colorectal cancer patients detected by mass survey and those from an outpatient clinic. Jpn Soc coloproctol (in Japanese) 1988; 41: 788–95.

12.

12. Hiwatashi N , Sato H , Miura M , et al. The present state and problems of accurate tests in mass survey for colorectal cancer. J Gastroenterol Mass Survey (in Japanese) 1989; 82: 15–21.

13.

13. Kewenter J , Bjork S , Hanglind E , et al. A controlled trial of feacal occult blood testing in 27, 700 subjects. Cancer 1988; 62: 64551.

14.

14. Kronborg O . Screening guideline for colorectal cancer. Scand J Gastroenterol 1992; 27: 123–9.

15.

15. Kronborg O , Fenger C , Sondergaard O , et al. Initial mass screening for colorectal cancer with fecal occult blood test. A prospective randomized study at Funen in Denmark. Scand J Gastroenterol 1987; 22: 677–86.

16.

16. Nakama H . A clinico-pathological study of mass screening for colorectal cancer with special emphasis on comparison of clinical stage and prognosis among the cases detected through repeated annual examination, initial examination and out-patient clinics. Shinshu Med J (in Japanese) 1992; 40: 325–36.

17.

17. Nakama H , Fujita M , Kamijo M , et al. A study on clinico-pathological features of colorectal cancer detected by mass survey with special emphasis on the significance of sequential screening. J Gastroenterol Mass Survey (in Japanese) 1992; 94: 41–7.

18.

18. Cole P , Morrison AS . Basic issue in population screening for cancer. JNCI 1980; 64: 1263–72.