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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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A Systematic Review of Repeat Fecal Occult Blood Tests for Colorectal Cancer Screening

Caitlin C. Murphy, Ahana Sen, Bianca Watson, Samir Gupta, Helen Mayo and Amit G. Singal
Caitlin C. Murphy
1Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas.
2Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas.
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  • For correspondence: Caitlin.Murphy@UTSouthwestern.edu
Ahana Sen
3Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.
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Bianca Watson
4Department of Psychiatry and Behavioral Sciences, Tulane School of Medicine, New Orleans, Louisiana.
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Samir Gupta
5Veterans Affairs San Diego Healthcare System, UC San Diego, San Diego, California.
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  • ORCID record for Samir Gupta
Helen Mayo
6Health Sciences Digital Library and Learning Center, UT Southwestern Medical Center, Dallas Texas.
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Amit G. Singal
2Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, Texas.
3Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.
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DOI: 10.1158/1055-9965.EPI-19-0775 Published February 2020
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Abstract

Screening with fecal occult blood tests (FOBT) reduces colorectal cancer mortality. Failure to complete repeat tests may compromise screening effectiveness. We conducted a systematic review of repeat FOBT across diverse health care settings. We searched MEDLINE, Embase, and the Cochrane Library for studies published from 1997 to 2017 and reported repeat FOBT over ≥2 screening rounds. Studies (n = 27 reported in 35 articles) measured repeat FOBT as (i) proportion of Round 1 participants completing repeat FOBT in Round 2; (ii) proportion completing two, consecutive FOBT; or (iii) proportion completing ≥3 rounds. Among those who completed FOBT in Round 1, 24.6% to 89.6% completed repeat FOBT in Round 2 [median: 82.0%; interquartile range (IQR): 73.7%–84.6%]. The proportion completing FOBT in two rounds ranged from 16.4% to 80.0% (median: 46.6%; IQR: 40.5%–50.0%), and in studies examining ≥3 rounds, repeat FOBT ranged from 0.8% to 64.1% (median: 39.2%; IQR: 19.7%–49.4%). Repeat FOBT appeared higher in mailed outreach (69.1%–89.6%) compared with opportunistic screening (24.6%–48.6%). Few studies examined correlates of repeat FOBT. In summary, we observed a wide prevalence of repeat FOBT, and prevalence generally declined in successive screening rounds. Interventions that increase and maintain participation in FOBT are needed to optimize effectiveness of this screening strategy.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2020;29:278–87

  • Received July 1, 2019.
  • Revision received August 29, 2019.
  • Accepted November 12, 2019.
  • Published first November 18, 2019.
  • ©2019 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 29 (2)
February 2020
Volume 29, Issue 2
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A Systematic Review of Repeat Fecal Occult Blood Tests for Colorectal Cancer Screening
Caitlin C. Murphy, Ahana Sen, Bianca Watson, Samir Gupta, Helen Mayo and Amit G. Singal
Cancer Epidemiol Biomarkers Prev February 1 2020 (29) (2) 278-287; DOI: 10.1158/1055-9965.EPI-19-0775

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A Systematic Review of Repeat Fecal Occult Blood Tests for Colorectal Cancer Screening
Caitlin C. Murphy, Ahana Sen, Bianca Watson, Samir Gupta, Helen Mayo and Amit G. Singal
Cancer Epidemiol Biomarkers Prev February 1 2020 (29) (2) 278-287; DOI: 10.1158/1055-9965.EPI-19-0775
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