Macafee, D.A.L.; Scholefield, J.H.; Whynes, D.K.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA28
Academic Journal
The Nottingham trial of Faecal occult blood (FOBT) screening, randomised 152 850 individuals between the ages of 45 and 74, with the identification of 1551 cancers and 1497 individuals with at least one adenoma, within the screened group. The distribution of colorectal cancers was 37% (576) in the rectum, 31% (484) in the left colon and 32% (491) proximal to or including the splenic flexure (right-sided lesions). Rectal cancers among males remained high (43%) compared with females (29%), while 39% (261) of female cancers were right-sided. Of those who had adenomas detected by colonoscopy, 80% (1201) had only one adenoma. Considering only the distribution of the index polyp of each individual, 91% (1358) were found distal to the splenic flexure. This is the first time a screening study has identified a right-sided shift in colorectal cancer distribution. This trend has been noted by other recent papers but not within a screening programme. This shift has important implications for any screening modality if a national screening programme is to be considered.


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