Impact of systematic false-negative test results on the performance of faecal occult blood screening

The impact of systematic false-negative test results on mortality reduction and on programme sensitivity of annual faecal occult blood testing in ages 50-84 years is explored using a microsimulation model. We made calculation s for test sensitivities of 80. 50 and 30%. In order to reproduce a cancer detection rate of 2.2 per 1000 at the first screening, the corresponding me an preclinical sojourn times had to be 1.42, 2.30 and 3.84 years, respectiv ely. The fraction systematic results among the false-negative results is va ried between 0 and 100%. With 80% lest sensitivity, the reduction in mortal ity Jul to screening decreases from 25% without systematic results to 23% w hen all false-negative results are systematic and the programme sensitivity decreases from 63 to 58%. With 30% test sensitivity, mortality reduction d ecreases from 21 to 11% and programme sensitivity decreases from 52 to 27%. The impact of systematic false-negative test results is important if annua l FOBT screening is considered. (C) 2001 Elsevier Science Ltd. All rights r eserved.