This association appeared to be stronger for men than for women, said Dr. Aasma Shaukat of the Minneapolis Veterans Affairs Health Care System and the University of Minnesota, Minneapolis, and her associates.
They performed a secondary analysis of data from the Minnesota Colon Cancer Control Study, in which 46,551 healthy men and women aged 50-80 years at baseline in 1975 through 1978 were randomly assigned to undergo annual, biennial, or no FOBT screening until 1993. Dr. Shaukat and her colleagues attempted to identify the mortality status and cause of death for as many of these study subjects as possible in 2011.
They identified 33,020 deaths, which represents 71% of the entire study population. A total of 732 deaths were from colorectal cancer.
Both annual and biennial FOBT screening reduced colorectal-cancer-specific mortality by approximately one-third for up to 30 years. The relative risk of death from colorectal cancer was 0.68 with annual FOBT and 0.78 with biennial FOBT, compared with no FOBT. Overall, the relative risk of death with any FOBT screening was 0.73, compared with no FOBT.
This reduction "is consistent with the effect of removing adenomas that would have progressed to cancer and death," Dr. Shaukat and her associates said (N. Engl. J. Med. 2013 [doi:10.1056/NEJMoa1300720]).
The decline in colorectal cancer-specific mortality was greater for men than for women.
"The high accessibility and acceptability of stool-based tests have major public health implications for improving screening rates, although this approach to screening involves more frequent testing than does screening with flexible sigmoidoscopy or colonoscopy," the investigators noted.
Dr. Nishihara’s study was supported by the National Institutes of Health, the Bennett Family Foundation, and the Entertainment Industry Foundation. Dr. Nishihara reported no ties to industry sources; one of her associates reported ties to Bayer Healthcare, Pfizer, Millenium Pharmaceuticals, and Pozen. Dr. Shaukat’s study was supported by the Veterans Affairs Merit Review Reward Program, the National Institutes of Health, and the National Cancer Institute. Dr. Shaukat and her associates reported no financial conflicts of interest.