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Most bowel cancers were left-sided in British screening program
Logan RFA. Gut. 2011;doi:10.1136/gutjnl-2011-300843.
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More than three-quarters of bowel cancers detected in a screening program in England were left-sided, possibly because right-sided cancers are more aggressive and more difficult to detect by screening.
In the Bowel Cancer Screening Programme, residents in England aged 60 to 69 years were offered three guaiac fecal occult blood tests every 2 years with the goal of reducing colorectal cancer mortality by 16% in those invited for screening. The program began in 2006, and almost 2.1 million people had been invited to participate by October 2008. Overall uptake was 52% — 49.6% in men and 54.4% in women.
In results from this analysis of the first 1.08 million returned tests, 2.5% of men and 1.5% of women had abnormal results, similar to what was observed in the pilot and the original European trials. More than 98% of those with abnormal results (n=17,518) underwent subsequent colonoscopy. Physicians determined that 43% of men and 29% of women screened had advanced colorectal neoplasia that required further treatment or investigation.
Seven in 10 cancers detected were early-stage disease. Researchers discovered 28.7% of cancers in the rectum or rectosigmoid colon. Men (28.5%) were more likely to have rectal cancer compared with women (20.3%). Overall, 77.3% of cancers were left-sided, whereas only 14.3% were right-sided. Right-sided disease was more common in women (19.2%) than in men (12.2%).
The most commonly reported adverse event was bleeding after polypectomy (n=42) reports. Most incidents were managed without hospitalization, but bleeding was serious enough to warrant admission in at least 12 cases.
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