Objective: A longitudinal study has been carried out in Asahi Village, Nagano, Japan to evaluate the efficacy of screening program for mortality reduction from colorectal cancer. Methodology: An immunochemical fecal occult blood (FOB) screening has been conducted in Asahi Village for the people aged 40 years and over in each year from 1982-1998. Total colonoscopy or barium enema was performed for positive cases, and endoscopic or surgical treatment was done for cancer or polyp. The identification of survival or death and false negative were checked through annual screening reports. Efficacy of the program was measured by standardized mortality ratio (SMR) for colorectal cancer through observing the changes in relative incidence. Results: The SMR in the study area was 142 before (1965-1981), and 62 during (1982-1998) the screening program (P<0.01). The change in the relative incidence showed 56.3% reduction. In comparison, SMR in the control area was 128 before and 116 during screening. The change in relative incidence was -9.4% in the control area. The reduction in the relative incidence of colorectal cancer was significantly higher in the study area than in the control area (P<0.01). Conclusion: The results of the present study suggest that screening using FOB lowers the population risk for colorectal cancer mortality, and FOB screening is effective as a preventive community measure in reducing the mortality. The time-trend assessment, employed here, is one of the useful methods for evaluating the efficacy of colorectal cancer screening.
Learning Objectives: Annual screening program using fecal occult blood test lowers the population risk for colorectal cancer mortality. Time-trend assessment may be one of the useful methods for evaluating the efficacy of colorectal cancer screening
Keywords: Cancer Screening, Mortality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.