SCREENING FOR COLORECTAL-CANCER IN MARKET-HARBOROUGH, UK - A COMMUNITY-BASED PROGRAM

Objective: To identify those groups of people who fail to participate in colorectal cancer screening programmes, using faecal occult blood tests, and to determine areas of diagnostic delay within such programmes. Design: General practitioners in Market Harborough, Leicestershire, UK, offered 4176 people aged from 50-70 years, registered with the practice, a free haemoccult test for the early detection of colorectal cancer. Methods: Compliance was measured according to age and gender. Those patients with positive faecal occult blood tests were investigated with colonoscopy. Results: The compliance rate was 38%, with more women participating than men (42 compared with 33%, chi2 = 37.2, P < 0.0001). This difference was due to younger women, aged 50-60 years, returning more kits than their male counterparts (47 compared with 32%, chi2 = 54.7, P < 0.0001). Two patients were diagnosed as having carcinoma (Dukes' C and D tumours) and a further four as having adenomatous polyps. Patients were allowed 1 month to complete repeat tests while on a restricted diet and to decide whether to undergo investigation. Conclusions: To achieve a high compliance rate in future programmes, all groups should be targeted, especially men and older women. In patients with positive initial tests found to have distal lesions, diagnosis may be advanced by an immediate rectal examination and rigid sigmoidoscopy.