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New Screening Improves Colon Cancer Detection Sensitivity

Logistic constraints may prevent widespread implementation

FRIDAY, Nov. 21 (HealthDay News) -- Primary screening for colorectal cancer using a new Finnish screening program based on experimental design has proven effective in preventing deaths in the preclinical phase, according to research published Nov. 20 in BMJ Online First.

Nea Malila, M.D., of the Finnish Cancer Registry in Helsinki, Finland, and colleagues estimated the sensitivity of colorectal cancer screening of the fecal occult blood test, randomizing 52,998 adults aged 60 to 69 to the screening arm and 53,002 to the control arm, covering 161 of the 431 municipalities in Finland between 2004 and 2006.

The fecal occult blood test, episode and program sensitivities were 54.6 percent, 51.3 percent and 37.5 percent, respectively, the report indicates. While test sensitivity refers to the proportion of cancer cases detected in the preclinical phase of the disease, episode sensitivity includes interval cancers missed in between screening tests. Program sensitivity is based on the proportion of total cancers detected among all participants, the authors note.

"Many programs will have to be phased in on the basis of the availability of facilities, the experience of health professionals, and the capacity of the service provider. Also, achieving informed consent from the entire target population for participating in this type of program implementation may be a problem for many countries. Therefore, logistically, randomization may not be possible in many situations, and implementation will depend on local circumstances," write Joan Austoker, Ph.D., and Paul Hewitson, of the University of Oxford, in an accompanying editorial.

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