ArticleBMJ open gastroenterology2015
Effectiveness of screening for colorectal cancer with a faecal occult-blood test, in Finland.
Article in BMJ open gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Effectiveness and Safety of Colorectal Cancer Screening Via Fecal Occult Blood Testing: A Systematic Review and Meta-Analysis.Journal of gastrointestinal cancer · 2026Pooled it
- Pooled it
- Assessment of cancer screening effectiveness in the era of screening programs.European journal of epidemiology · 2020Pooled it
- Colorectal cancer screening with faecal testing, sigmoidoscopy or colonoscopy: a systematic review and network meta-analysis.BMJ open · 2019Pooled it
- The compliance rate for the second diagnostic evaluation after a positive fecal occult blood test: A systematic review and meta-analysis.United European gastroenterology journal · 2019Pooled it
- Sex-Specific Outcomes after a Negative Colonoscopy in the Finnish Randomized Health Service Study during 2004 to 2016.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Trial
- Sex differences in faecal occult blood test screening for colorectal cancer.The British journal of surgery · 2019Trial
- Invitation for FOBt screening and colorectal cancer mortality: A prospective analysis in the Million Women Study cohort.International journal of cancer · 2025Article
- Recent trends in self-reported utilization of colonoscopy and fecal occult blood test in Europe: analysis of the European Health Interview Surveys 2013-2015 and 2018-2020.European journal of epidemiology · 2025Article
- Early detection efforts for colorectal and prostate cancer from the patient's perspective over the course of 12 years: results of the KABOT survey study.Primary health care research & development · 2024Article
- Routine Fecal Occult Blood Screening and Colorectal Cancer Mortality in Sweden.JAMA network open · 2024Article
- Review
- Use of health services one year before primary colorectal cancer.BMC health services research · 2023Article
- Screening for Colorectal Cancer.Hematology/oncology clinics of North America · 2022Review
- Faecal haemoglobin concentrations in women and men diagnosed with colorectal cancer in a national screening programme.Journal of medical screening · 2022Article
- Aspects of colorectal cancer screening, methods, age and gender.Journal of internal medicine · 2021Review
- Piloting gender-oriented colorectal cancer screening with a faecal immunochemical test: population-based registry study from Finland.BMJ open · 2021Article
- Article
- Microbial markers in colorectal cancer detection and/or prognosis.World journal of gastroenterology · 2018Review
- The IARC Perspective on Colorectal Cancer Screening.The New England journal of medicine · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundScreening for colorectal cancer (CRC) with guaiac-based faecal occult-blood test (FOBT) has been reported to reduce CRC mortality in randomised trials in the 1990s, but not in routine screening, so far. In Finland, a large randomised study on biennial FOB screening for CRC was gradually nested as part of the routine health services from 2004. We evaluate the effectiveness of screening as a public health policy in the largest population so far reported.
methodsWe randomly allocated (1:1) men and women aged 60-69 years to those invited for screening and those not invited (controls), between 2004 and 2012. This resulted in 180 210 subjects in the screening arm and 180 282 in the control arm. In 2012, the programme covered 43% of the target age population in Finland.
resultsThe median follow-up time was 4.5 years (maximum 8.3 years), with a total of 1.6 million person-years. The CRC incidence rate ratio between the screening and control arm was 1.11 (95% CI 1.01 to 1.23). The mortality rate ratio from CRC between the screening and control arm was 1.04 (0.84 to 1.28), respectively. The CRC mortality risk ratio was 0.88 (0.66 to 1.16) and 1.33 (0.94 to 1.87) in males and females, respectively.
conclusionsWe did not find any effect in a randomised health services study of FOBT screening on CRC mortality. The substantial effect difference between males and females is inconsistent with the evidence from randomised clinical trials and with the recommendations of several international organisations. Even if our findings are still inconclusive, they highlight the importance of randomised evaluation when new health policies are implemented.
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