PTH-009 Colorectal cancer diagnoses in non-responders to Bowel Cancer Screening Programme and faecal occult blood negative responders

Abstract

Introduction All 60–69-year-olds in the North of Tyne (NOT) Bowel cancer screening (BCS) catchment population have been offered faecal occult blood (FOB) testing since February 2008. All FOB positive patients are offered colonoscopy. We have studied the frequency of colorectal cancer (CRC) diagnoses in patients who declined FOB testing and those who accepted but were FOB negative. Methods All patients aged 60–69 who were referred to the three colorectal multidisciplinary teams (MDT) serving the NOT BCS catchment population between February 2008 and September 2009 wih CRC were identified. These patients were cross-referenced with the BCS database and their FOB testing status ascertained as positive, negative, no response, opt out or known previous diagnosis of CRC. Results Total number of patients with CRC=507 Number of patients with pre-existing colorectal cancer diagnosis excluded from analysis=206 Number of CRC patients potentially diagnosable through BCS=301 Number diagnosed through BCS=80 (26.5%) Number with negative FOB=42 (14.0%) Number of non-responders=133 (44.1%) Number of opt outs=46 (15.2%) Of all patients with CRC who had FOB testing, 65.6% were positive and 34.4% were negative Conclusion 26.5% of 60–69-year-olds in the NOT BCS area with CRC are being diagnosed by the programme. FOB testing misses 34.4% of cases. 179 (59.3%) of patients with CRC were non-responders or opt outs, and of these 65.6% might have been diagnosed earlier had they agreed to participate.