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Br J Cancer. 2012 Jul 10;107(2):255-9. doi: 10.1038/bjc.2012.277. Epub 2012 Jun 26.

The impact of population-based faecal occult blood test screening on colorectal cancer mortality: a matched cohort study.

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  • 1Scottish Bowel Screening Research Unit, Kings Cross, Clepington Road, Dundee DD3 8EA, UK.



Randomised trials show reduced colorectal cancer (CRC) mortality with faecal occult blood testing (FOBT). This outcome is now examined in a routine, population-based, screening programme.


Three biennial rounds of the UK CRC screening pilot were completed in Scotland (2000-2007) before the roll out of a national programme. All residents (50-69 years) in the three pilot Health Boards were invited for screening. They received a FOBT test by post to complete at home and return for analysis. Positive tests were followed up with colonoscopy. Controls, selected from non-pilot Health Boards, were matched by age, gender, and deprivation and assigned the invitation date of matched invitee. Follow-up was from invitation date to 31 December 2009 or date of death if earlier.


There were 379 655 people in each group (median age 55.6 years, 51.6% male). Participation was 60.6%. There were 961 (0.25%) CRC deaths in invitees, 1056 (0.28%) in controls, rate ratio (RR) 0.90 (95% confidence interval (CI) 0.83-0.99) overall and 0.73 (95% CI 0.65-0.82) for participants. Non-participants had increased CRC mortality compared with controls, RR 1.21 (95% CI 1.06-1.38).


There was a 10% relative reduction in CRC mortality in a routine screening programme, rising to 27% in participants.

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