Posted on March 8th, 2009 by
The implementation of colorectal cancer screening appears to reduce mortality from the disease, as evidenced by the disparity between mortality rates among regions that implemented screening at different times. The results of this study were published in the Journal of the National Cancer Institute.
Colorectal cancer is the second leading cause of cancer-related deaths in the United States. The disease develops in the large intestine, which includes the colon (the longest part of the large intestine) and the rectum (the last several inches).
Because colorectal cancer is a type of cancer that is highly curable in early stages, universal screening of individuals remains of utmost importance in order to improve overall outcomes for the disease. In the United States and Europe, colorectal cancer incidence and mortality are on the decline, which is possibly related to the implementation of regular screening. One common screening procedure is the fecal occult-blood test (FOBT), which checks for hidden blood in the stool.
In an effort to evaluate the efficacy of colorectal cancer screening, researchers in Italy compared the colorectal cancer mortality rates of two geographic areas in the provinces of Florence and Prato in the Tuscany region of Italy that implemented screening programs at different times. The Empolese-Mugello district began screening with FOBT in the early 1980s, whereas the rest of the Florence and Prato provinces began in early 2000. In the Empolese-Mugello district, approximately 175,000 people were tested each year with FOBT compared with approximately 38,000 in the rest of the Florence and Prato provinces (beginning about 15 years later).
The results of the analysis indicated that the Empolese-Mugello district had a greater decrease in colorectal cancer mortality than the rest of the Florence and Prato provinces. The estimated annual reduction in age-adjusted colorectal cancer mortality was 2.7% in the Empolese-Mugello district compared with 1.3% in the rest of the Florence and Prato provinces.
The researchers concluded that the “observed difference in colorectal cancer mortality is due to earlier exposure to fecal occult blood test screening.”
 Costantini AS, Martini A, Puliti D, et al. Colrectal cancer mortality in two areas of Tuscany with different screening exposures. Journal of the National Cancer Institute. 2008; 100:1818-1821.
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