SCREENING FOR COLORECTAL-CANCER - A GENERAL-PRACTICE-BASED STUDY

Background. A 2-year study was undertaken to determine the best way of setting up faecal occult blood screening for colorectal cancer in a s ingle general practice in north Birmingham, a district with no pre-exi sting hospital-based screening programme for colorectal cancer. This p rogramme was set up in close collaboration with the Departments of Sur gery and Biochemistry at the local Good Hope Hospital Trust. This faci litated joint meetings between the staff of these hospital departments and the practice manager, who was responsible for organization of the study at the Hawthorns Surgery and also supervised the day-to-day run ning of the programme. Essentially, the study was organized and run by the practice manager and nurse. Aim. The study was undertaken to prep are the way for other general practices in north Birmingham to screen selected populations for colorectal cancer. Method. A Haemoccult test kit was posted to patients together with an explanatory letter. The de sign of the screening programme was similar to the design of the 'scre ened arm' of the Medical Research Council (MRC) colorectal screening t rial in Nottingham. On completion of the programme, questionnaires wer e posted to 100 responders and 100 non-responders to assess the level of patient acceptability for the screening study. A total of 3509 pati ents (1599 men and 1910 women) were invited to take part in the screen ing. Results. The response rate was 55.4%. Thirty-nine patients were r eferred from the screening study for further investigation. Colonoscop y identified nine adenomas in nine patients, and a further 12 patients were found to have colorectal carcinoma. Conclusions. The findings fr om the study suggest that this method could be used as a model for oth er general practices introducing colorectal screening using Haemoccult .