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Evidence That Really Matters

Controlled prospective study of faecal occult blood screening for colorectal cancer in Bury, black pudding capital of the world

BMJ 2002; 325 doi: (Published 21 December 2002) Cite this as: BMJ 2002;325:1444
  1. Stuart Fludger, senior house officer in anaesthesiaa,
  2. Anne-Marie Turner, specialist registrar in gastroenterologyb,
  3. Richard F Harvey, consultant gastroenterologistc,
  4. Neil Haslam, consultant gastroenterologist (
  1. a Royal Liverpool University Hospital, Liverpool L7 8XP
  2. b Royal Preston Hospital, Preston PR2 4HT
  3. c Frenchay Hospital, Bristol BS16 1LE
  4. d Fairfield General Hospital, Bury BL9 7TD
  1. Correspondence to: N Haslam

    Colorectal cancer is the second most common cause of death from cancer in the United Kingdom, claiming 20 000 lives each year. Most cancers originate from malignant transformation of adenomas, and screening the general population to detect asymptomatic adenomas and early cancers shows the greatest potential to reduce mortality. In the most evaluated screening protocol, small volumes of blood loss from such lesions are detected by a faecal occult blood test, and people testing positive then have a colonoscopy. This reduces mortality in two ways: detection and endoscopic removal of adenomas prevents later transformation and may reduce the incidence of cancer by 16%1; and early detection of carcinomas allows treatment of less advanced lesions, resulting in a better prognosis. A large trial of such screening showed that a 15% reduction in mortality from colorectal cancer can be achieved. …

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