67% for round 1; more than 90% for repeat screenings.

Controls continued to seek usual

Predictive value of positive FOBT: 17% in first round tp, 9% in final round; PPV for large adenomas was 32% at first round, 21% at final round.


TABLE 24.6. Evidence for the efficacy of colorectal cancer screening. (continued)

Exposure or intervention Screening Relative risk (RR) or

Years of Longest Age Study and screening interval % Exposed to odds ratio (OR) of colon

Study intervention follow-up Site of study group design rounds (months) intervention Contamination cancer mortality Comment



Winawer134 1975-1979 9 years


Kaiser Permanente Medical Care Program, Oakland, CA

45 or older


Greater 20-75



Health Plan members


Recipients of 40 and self-paid older comprehensive medical examinations, Strang Clinic

US military Mean veterans age 57


Prospective cohort


Rigid sigmoidoscopy

(single exposure)


(single exposure)

FOBT + rigid sigmoidoscopy compared with rigid sigmoidoscopy alone

Endoscopy (sigmoidoscopy, colonoscopy) and/or tissue removal (at least one exposure)

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