Hardcastle J D, Thomas W M, Chamberlain J, Pye G, Sheffield J, James P D, Balfour T W, Amar S S, Armitage N C, Moss S M
Department of Surgery, University Hospital, Nottingham.
Lancet. 1989 May 27;1(8648):1160-4. doi: 10.1016/s0140-6736(89)92750-5.
To assess the effectiveness of screening by faecal occult blood tests, 107,349 people without symptoms of colorectal disease identified from general practitioner records have been randomly allocated to test and control groups. 53,464 test subjects were invited to carry out the screening test; 27,651 (53%) of the 52,258 who received the tests did so. Further investigation of the 618 (2.3%) with positive tests showed 63 cancers (52% stage A) and 367 adenomas (266 subjects). Rescreening of subjects with negative results every 2 years (9510 first rescreen, 3639 second) has shown a significant fall in the rate of positive results (1.7% of 7344; 0.3% of 2906). Cancers have also been diagnosed in 20 subjects presenting in the interval between a negative test and rescreening, and in 83 non-responders. The incidence of cancer in the control group (123 subjects; 10.6% stage A) was 0.72 per 1000 person-years. Cancers detected by screening were at a less advanced pathological stage, but it is too early to show any effect of screening on mortality from colorectal cancer.
为评估粪便潜血试验筛查的有效性，从全科医生记录中确定了107349名无结直肠疾病症状的人，并随机分为试验组和对照组。邀请53464名试验对象进行筛查试验；在52258名接受检测的对象中，有27651名（53%）进行了检测。对618名（2.3%）检测呈阳性的对象进一步调查发现63例癌症（52%为A期）和367例腺瘤（涉及266名对象）。每2年对检测结果为阴性的对象进行重新筛查（首次重新筛查9510人，第二次3639人），结果显示阳性率显著下降（7344人中为1.7%；2906人中为0.3%）。在检测结果为阴性与重新筛查的间隔期内，也有20名对象被诊断出患有癌症，83名未响应者也被诊断出患有癌症。对照组的癌症发病率（123名对象；10.6%为A期）为每1000人年0.72例。筛查发现的癌症处于较早期的病理阶段，但要显示筛查对结直肠癌死亡率的任何影响还为时过早。
