To the Editor: The recent report by the Multicentre Australian Colorectal-neoplasia Screening (MACS) Group1 offered some intriguing findings. Participation in bowel cancer screening was lower than expected, despite a range of tests being offered. In addition, people offered a choice of different faecal occult blood tests (FOBTs) were less likely to participate than those not offered this choice. The accompanying editorial by Salkeld and colleagues concluded that “Informed consumers making smart choices about screening . . . would be a public health success”.2 We believe the available evidence indicates otherwise.
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- The Canberra Hospital, Garran, ACT.
- 1. The Multicentre Australian Colorectal-neoplasia Screening (MACS) Group. A comparison of colorectal neoplasia screening tests: a multicentre community-based study of the impact of consumer choice. Med J Aust 2006; 184: 546-550. <MJA full text>
- 2. Salkeld GP, Young JM, Solomon MJ. Consumer choice and the National Bowel Cancer Screening Program [editorial]. Med J Aust 2006; 184: 541-542. <MJA full text>
- 3. Bowel Cancer Screening Pilot Monitoring and Evaluation Steering Committee. Australia’s bowel cancer screening pilot and beyond: final evaluation report. Canberra: Australian Government Department of Health and Ageing, 2005. http://www.cancerscreening.gov.au/bowel/bcaust/pilot.htm (accessed Jun 2006).
- 4. Corbett M, Chambers SL, Shadbolt B, et al. Colonoscopy screening for colorectal cancer: the outcomes of two recruitment methods. Med J Aust 2004; 181: 423-427. <MJA full text>
- 5. Segnan N, Senore C, Andreoni B, et al. Randomized trial of different screening strategies for colorectal cancer: patient response and detection rates. J Natl Cancer Inst 2005; 97: 347-357.
- 6. Jepson RG, Forbes CA, Sowden AJ, Lewis RA. Increasing informed uptake and non-uptake of screening: evidence from a systematic review. Health Expect 2001; 4: 116-126.
- 7. Ransohoff DF. Challenges and opportunities in evaluating diagnostic tests. J Clin Epidemiol 2002; 55: 1178-1182.