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Downstaging of colorectal cancer by the national bowel cancer screening programme in England: first round data from the first centre
Article first published online: 19 OCT 2009
DOI: 10.1111/j.1463-1318.2009.02069.x
© 2010 The Authors. Journal Compilation © 2010 The Association of Coloproctology of Great Britain and Ireland
Additional Information
How to Cite
Ellul, P., Fogden, E., Simpson, C. L., Nickerson, C. L. R., Mckaig, B. C., Swarbrick, E. T. and Veitch, A. M. (2010), Downstaging of colorectal cancer by the national bowel cancer screening programme in England: first round data from the first centre. Colorectal Disease, 12: 420–422. doi: 10.1111/j.1463-1318.2009.02069.x
Publication History
- Issue published online: 8 APR 2010
- Article first published online: 19 OCT 2009
- Received 20 March 2009; accepted 14 June 2009; Accepted Article online 19 October 2009
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Keywords:
- Colorectal cancer;
- screening;
- faecal occult blood test;
- colonoscopy
Abstract
Objective Data from randomized controlled trials of Colorectal Cancer (CRC) screening in Nottingham, UK and Funen, Denmark and pilot data from the English and Scottish arms of the National Bowel Cancer Screening Programme (NBCSP) have demonstrated predominantly early-stage disease amongst the screened population. The aim of this study was to investigate whether downstaging of cancers occurred in the NBCSP in Wolverhampton.
Method A case–control study was performed to compare the staging of CRC diagnosed in the NBCSP-screened population during the prevalent round (2 years) of screening, with cancers diagnosed prior to the introduction of the NBCSP.
Results The total population in the screening area is 899 000. A total of 108 346 FOB kits were sent out of which 55 931 were returned (51.6% uptake), A total of 1039 colonoscopies were performed with a 94.75% unadjusted caecal intubation rate. There were three complications (haemorrhages 3) and no perforations. The NBCSP in Wolverhampton identified 106 (75% male) CRC in the first 2 years with 45.3% Dukes A, 21.7% B, 29.2% C and 3.8% D. Two hundred and fifty-six (61% male) CRC were identified in the control group, 10.1% Dukes A, 50.0% B, 36.3% C and 3.5% D. There was a highly significant shift towards earlier stage disease in the screened group (P < 0.0001).
Conclusion The 2-year data from the first English centre to start bowel cancer screening demonstrates significant downstaging of cancer, consistent with both the RCT and pilot data.