Z Gastroenterol 2008; 46: 17-19
DOI: 10.1055/s-2007-963480

© Georg Thieme Verlag KG Stuttgart · New York

Evidence, Efficacy and Effectiveness of Screening for Colorectal Cancer with Faecal Tests

J. Faivre1 , C. Lepage1
  • 1Registre des Cancers (INSERM U 866, BP 87900, 21079 Dijon, France) et CHU de Dijon
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26. März 2008 (online)


Colorectal cancer fulfils the conditions that have been defined for mass screening: it is a major cause of morbidity and mortality in industrialised countries with an estimated number of 213 000 new cases reported in the 15 member states of the European Union in 1996. Despite advances in diagnostic techniques and treatment, the five-year survival rates remain poor. However, colorectal cancer can be cured if detected at an early stage and in certain cases can be prevented by the removal of adenomas. Considerable research efforts have been launched over the last 15 years to evaluate the ability of screening tests’ to decrease colorectal cancer mortality and incidence. Currently, the most simple screening method for colorectal cancer is periodic stool testing for occult blood. The most extensively evaluated test is the Hemoccult II (Smith Kline Diagnostic, California). The purpose of this paper is to consider the evidence for screening for colorectal cancer based on published studies and to present the French screening programme.


  • 1 Kronborg O, Fenger C, Olsen J. et al . Randomized study as screening for colorectal cancer with faecal-occult-blood test.  Lancet. 1996;  348 1467-1471
  • 2 Hardcastle J D, Chamberlain J O, Robinson M HE. et al . Randomized controlled trial of faecal-occult-blood screening for colorectal cancer.  Lancet. 1996;  348 1472-1477
  • 3 Faivre J, Dancourt V, Lejeune C. et al . Reduction in colorectal cancer mortality by fecal occult blood screening in a controlled study in France.  Gastroenterology. 2004;  126 1674-1680
  • 4 Mandel J S, Bond J H, Church T R. et al . Reducing mortality from colorectal cancer by screening for faecal occult blood.  N Engl J Med. 1993;  328 1365-1371
  • 5 Jouve J L, Remontet L, Dancourt V. et al . Estimation of screening test (Hemoccult) sensitivity in colorectal cancer mass screening.  Br J Cancer. 2001;  84 1477-1481
  • 6 Bertario L, Spinelli P, Gennari L. et al . Sensitivity of Hemoccult test for large bowel cancer in high-risk subjects.  Dig Dis Sci. 1988;  33 609-613
  • 7 Mandel J S, Church T R, Ederer F. et al . Colorectal cancer mortality: effectiveness of biennial screening for fecal occult blood.  J Natl Cancer Inst. 1999;  91 434-437
  • 8 Mandel J S, Church T R, Bond J H. et al . The effect of fecal occult-blood screening on the incidence of colorectal cancer.  N Engl J Med. 2000;  343 1603-1607
  • 9 Lang C A, Ransohoff D F. Facal occult blood screening for colorectal cancer: is mortality reduced by chance selection for screening colonoscopy?.  JAMA. 1994;  271 1011-1013
  • 10 Tazi M A, Faivre J, Dassonville F. et al . Participation in faecal occult blood screening for colorectal cancer in a well defined French population : results of five screening rounds from 1988 to 1996.  J Med Screening. 1997;  4 147-151
  • 11 Morikawa T, Kato J, Yamaji Y. et al . A comparison of the immunochemical fecal occult blood test and total colonoscopy in the asymptomatic population.  Gastroenterology. 2005;  129 422-428
  • 12 Guittet L, Bouvier V, Mariotte N. et al . Comparison of a guaiac-based and an immunochemical fecal occult blood test in screening for colorectal cancer in a general average-risk population.  Gut. 2007;  56 210-214
  • 13 Imperiale T F, Rahsohoff D F, Itzkowitz S H. et al . Fecal DNA versus fecal occult blood for colorectal-cancer screening in an average-risk population.  N Engl J Med. 2004;  351 2704-2714

Jean Faivre

Hôpital du Bocage, Hépato-Gastroentérologie

2, Bd Mal de Lattre de Tassigny

21034 Dijon Cedex, France

Telefon: ++ 33/3/80 29/37 50

Fax: ++ 33/3/80 29/37 22

eMail: jean.faivre@chu-dijon.fr