Comité Départemental Des Cancers (CDC-93), 41 avenue de Verdun, 93146, Bondy, France. Hôpital Avicenne (AP-HP), Service d'Hépato Gastro Entérologie, 125 Rue de Stalingrad, 93000, Bobigny, France.
Am J Gastroenterol. 2018 Dec;113(12):1891-1899. doi: 10.1038/s41395-018-0367-2. Epub 2018 Oct 18.
To estimate the change in the participation rate and the change in neoplasia incidence before and after the change of the Fecal Occult Blood Test (FOBT) in the cohort included in the Colorectal Cancer Screening Program (CRCSP).
Cohort of 279,210 people, aged 50-74 years, invited at least once before 2009, to participate in a CRCSP campaign. The participation rate and the cumulative neoplasia incidence were described on 4 campaigns (≤2008, 2009-2010, 2011-2012 and 2013-2014) with a Guaiac FOBT (gFOBT) and a first campaign (2015-2016) with a Fecal Immunochemical Test (FIT). The cumulative incidence was estimated by the actuarial method and its confidence interval by the Greenwood method.
The participation rate decreased from 32.7% (first gFOBT-campaign) to 24.4% (fourth gFOBT-campaign) then, made a significant bound in the FIT-campaign (28.4%; p < 0.001). 35.4% of the 965 high-risk-polyps screened in this cohort were detected in the FIT-campaign. CRC incidence gradually decreased from 0.4 to 0.1/1000 person-years from the first to the fourth gFOBT-campaign before reaching a bound to 0.4/1000 person-years in the FIT-campaign.
Although it was still below the minimum European target (45%), the participation rate has increased between the last gFOBT-campaign and FIT-campaign, justifying the impact of promotional campaigns and the acceptance of the new test by people and GPs. A decline in the neoplasia incidence was observed between the initial and the fourth gFOBT-campaign. The change from gFOBT to FIT between the fourth and fifth campaigns, was associated with a significant increase in detection of neoplasia.
估计在大肠癌筛查计划（CRCSP）纳入的队列中，粪便潜血试验（FOBT）改变前后的参与率和肿瘤发病率的变化。
对 279210 名年龄在 50-74 岁的人群进行了队列研究，这些人至少在 2009 年之前被邀请参加过一次 CRCSP 活动。使用愈创木脂粪便潜血试验（gFOBT）和第一次试验（2015-2016 年）的粪便免疫化学试验（FIT），对 4 次活动（2008 年及以前、2009-2010 年、2011-2012 年和 2013-2014 年）的参与率和累积肿瘤发病率进行了描述。累积发病率采用 actuarial 法估计，置信区间采用 Greenwood 法。
参与率从第一次 gFOBT 活动的 32.7%下降到第四次 gFOBT 活动的 24.4%，然后在 FIT 活动中显著下降（28.4%；p<0.001）。在该队列中筛查的 965 个高危息肉中，有 35.4%在 FIT 试验中被检出。CRC 发病率从第一次 gFOBT 活动的 0.4 人年/1000 人逐渐下降到第四次 gFOBT 活动的 0.1 人年/1000 人，然后在 FIT 活动中达到 0.4 人年/1000 人。
尽管参与率仍低于欧洲最低目标（45%），但在最后一次 gFOBT 活动和 FIT 活动之间有所提高，证明了宣传活动的影响以及人们和全科医生对新检测的接受程度。在初始 gFOBT 活动和第四次 gFOBT 活动之间，肿瘤发病率呈下降趋势。第四次和第五次活动中，从 gFOBT 转为 FIT，与肿瘤发病率的显著增加有关。
