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Impact of changes to the interscreening interval and faecal immunochemical test threshold in the national bowel cancer screening programme in England: results from the FIT pilot study.
Li, Shuping J; Seedher, Tara; Sharples, Linda D; Benton, Sally C; Mathews, Christopher; Gabe, Rhian; Sasieni, Peter; Duffy, Stephen W.
  • Li SJ; Wolfson Institute of Population Health, Queen Mary University of London, London, UK. joy.li@qmul.ac.uk.
  • Seedher T; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
  • Sharples LD; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
  • Benton SC; NHS Bowel Cancer Screening Programme, Southern Hub, Royal County Hospital NHS Foundation Trust, Guildford, Surrey, UK.
  • Mathews C; School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
  • Gabe R; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
  • Sasieni P; School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.
  • Duffy SW; Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Br J Cancer ; 127(8): 1525-1533, 2022 11.
Article in English | MEDLINE | ID: covidwho-1991565
ABSTRACT

INTRODUCTION:

The NHS Bowel Cancer Screening Programme (BCSP) faces endoscopy capacity challenges from the COVID-19 pandemic and plans to lower the screening starting age. This may necessitate modifying the interscreening interval or threshold.

METHODS:

We analysed data from the English Faecal Immunochemical Testing (FIT) pilot, comprising 27,238 individuals aged 59-75, screened for colorectal cancer (CRC) using FIT. We estimated screening sensitivity to CRC, adenomas, advanced adenomas (AA) and mean sojourn time of each pathology by faecal haemoglobin (f-Hb) thresholds, then predicted the detection of these abnormalities by interscreening interval and f-Hb threshold.

RESULTS:

Current 2-yearly screening with a f-Hb threshold of 120 µg/g was estimated to generate 16,092 colonoscopies, prevent 186 CRCs, detect 1142 CRCs, 7086 adenomas and 4259 AAs per 100,000 screened over 15 years. A higher threshold at 180 µg/g would reduce required colonoscopies to 11,500, prevent 131 CRCs, detect 1077 CRCs, 4961 adenomas and 3184 AAs. A longer interscreening interval of 3 years would reduce required colonoscopies to 10,283, prevent 126 and detect 909 CRCs, 4796 adenomas and 2986 AAs.

CONCLUSION:

Increasing the f-Hb threshold was estimated to be more efficient than increasing the interscreening interval regarding overall colonoscopies per screen-benefited cancer. Increasing the interval was more efficient regarding colonoscopies per cancer prevented.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Adenoma / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: Br J Cancer Year: 2022 Document Type: Article Affiliation country: S41416-022-01919-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / Adenoma / COVID-19 Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: Br J Cancer Year: 2022 Document Type: Article Affiliation country: S41416-022-01919-y