Imperial College London
Portrait Picture

Professor Amanda Cross

Faculty of Medicine, School of Public Health

Professor of Cancer Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 3338amanda.cross

 
 
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Assistant

 

Mr Will Kay +44 (0)20 7594 3350

 
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Location

 

Room 1089Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Brown:2019:10.1177/0969141318785654,
author = {Brown, JP and Wooldrage, K and Kralj-Hans, I and Wright, S and Cross, A and Atkin, W},
doi = {10.1177/0969141318785654},
journal = {Journal of Medical Screening},
pages = {11--18},
title = {Effect of once-only flexible sigmoidoscopy screening on the outcomes of subsequent faecal occult blood test screening},
url = {http://dx.doi.org/10.1177/0969141318785654},
volume = {26},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objectives:To investigate the outcomes of biennial guaiac faecal occult blood test (gFOBT) screening after once-only flexible sigmoidoscopy (FS) screening. Methods:Between 1994 and 1999, as part of the UK FS Screening Trial (UKFSST), adults aged 55-64 years were randomly allocated to an intervention group (offered FS screening) or a control group (not contacted). From 2006, a subset of UKFSST participants (20,895/44,041 intervention group; 41,497/87,149 control group) were invited to biennial gFOBT screening by the English Bowel Cancer Screening Programme. We analysed gFOBT uptake, test positivity, yield of colorectal cancer (CRC), and positive predictive value (PPV) for CRC, advanced adenomas (AA), and advanced colorectal neoplasia (ACN: AA/CRC). Results:Uptake of gFOBT at first invite was 1.9% lower (65.7% vs. 67.6%, p<0.01) among intervention versus control group participants; positivity was 0.4% lower (2.0% vs. 2.4%, p<0.01); and CRC yield was 0.08% lower (0.19% vs. 0.27%, p=0.14).  PPVs were also lower in the intervention versus control group at 10.3% vs. 12.3% (p=0.44) for CRC, 22.7% vs. 31.4% (p<0.01) for AA, and 33.0% vs. 43.7% (p<0.01) for ACN. Among those who refused FS (n=5,532), gFOBT uptake at first invite was 47.7%, CRC yield was 0.25%, and PPV for ACN was 46.2%; among FS attenders (n=15,363), uptake was 72.2%, CRC yield was 0.18%, and PPV for ACN was 27.9%. Conclusions:Uptake, positivity and PPV of gFOBT screening were reduced following prior offer of FS screening. However, a quarter of FS screened participants receiving a diagnostic examination after positive gFOBT were diagnosed with ACN.
AU  - Brown,JP
AU  - Wooldrage,K
AU  - Kralj-Hans,I
AU  - Wright,S
AU  - Cross,A
AU  - Atkin,W
DO  - 10.1177/0969141318785654
EP  - 18
PY  - 2019///
SN  - 0969-1413
SP  - 11
TI  - Effect of once-only flexible sigmoidoscopy screening on the outcomes of subsequent faecal occult blood test screening
T2  - Journal of Medical Screening
UR  - http://dx.doi.org/10.1177/0969141318785654
UR  - http://hdl.handle.net/10044/1/61149
VL  - 26
ER  -
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