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

Introduction

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.

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