A national rollout of faecal occult-blood screening, federally funded, is the best approach
Bowel cancer is Australia’s commonest internal cancer.1 There is indisputable evidence that population screening with faecal occult-blood testing (FOBT), allowing early detection of cancer and detection and removal of the precursor adenomatous polyp, could save close to 2000 lives each year.2 The federal government is to be commended on its orderly approach to the issue through the Bowel Cancer Screening Pilot Programme (www.cancerscreening.gov.au/bowel/). It is important that this commitment to colorectal cancer screening continues, given also its clear cost-effectiveness.3-6
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- 1. Towler B, Irwig L, Glasziou P, et al. A systematic review of the effects of screening for colorectal cancer using the faecal occult blood test, hemoccult. BMJ 1998; 317: 559-565.
- 2. Australian Institute of Health and Welfare (AIHW). Australian Association of Cancer Registries (AACR). Cancer in Australia 2000. Canberra: AIHW, 2003. (AIHW Catalogue No. CAN 18. Cancer series no. 23.). Available at: www.aihw.gov.au/publications/index.cfm/title/9469 (accessed Nov 2004).
- 3. Steele RJ, Gnauck R, Hrcka R, et al. Methods and economic considerations: report from the ESGE/UEGF workshop on colorectal cancer screening. Endoscopy 2004; 36: 349-353.
- 4. Bolin TD, Lapsley HM, Korman MG. Screening for colorectal cancer: what is the most cost-effective approach? Med J Aust 2001; 174: 298-301.
- 5. Gow J. Costs of screening for colorectal cancer: an Australian programme. Health Econ 1999; 8: 531-540.
- 6. O’Leary BA, Olynk JK, Neville AM, Platell CF. Cost-effectiveness of colorectal cancer screening: comparison of community-based flexible sigmoidoscopy with fecal occult blood testing and colonoscopy. J Gastroenterol Hepatol 2004; 19: 38-47.
- 7. Viiala CH, Zimmerman M, Cullen DJ, Hoffman NE. Complication rates of colonoscopy in an Australian teaching hospital environment. Intern Med J 2003; 33: 355-359.
- 8. Wise KN. Solid cancer risks from radiation exposure for the Australian population. Australas Phys Eng Sci Med 2003; 26: 53-62.
- 9. Pickhardt PJ, Choi JR, Butler JA, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003; 349: 2191-2200.
- 10. Sosna J, Morrin MM, Kriskal JB, et al. CT colonography of colorectal polyps: a metaanalysis. Am J Roentgenol 2003; 181: 1593-1598.
- 11. Cotton PB, Durkalski VL, Pineau BC, et al. Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA 2004; 291: 1713-1719.
- 12. Gluecker T, Meuwly JY, Pescatore P, et al. Effect of investigator experience in CT colonography. Eur Radiol 2002; 12: 1405-1409.
- 13. Edwards JT, Mendelson RM, Fritschi L, et al. Colorectal neoplasia screening with CT colonography in average risk asymptomatic subjects: community-based study. Radiology 2004; 230: 459-464.
- 14. Scott RG, Edwards JT, Fritschi L, et al. Community-based screening by colonoscopy or computed tomographic colonography in asymptomatic average-risk subjects. Am J Gastroenterol 2004; 99: 1145-1151.
- 15. Winawer S, Fletcher R, Rex D, et al. Colorectal screening and surveillance: clinical guidelines and rationale — update based on new evidence. Gastroenterology 2003; 124: 544-560.
- 16. Smith A, Young GP, Cole S, et al. A quantifiable fecal immunochemical test (FIT) for hemoglobin facilitates balancing sensitivity and specificity when screening for colorectal cancer. Gastroenterology 2004; 125: A272.
Member of the Medical Advisory Board of Enterix Australia, 2001–2003; and Member, Monitoring and Evaluation Committee, Bowel Cancer Screening Pilot Programme, Australian Government Department of Health and Ageing.