One in five cancers is diagnosed through organized colorectal cancer screening program.

OC Sensor is the screening test with the best sensitivity, at 83.7 %.

OC Sensor has the lowest interval cancer rate, at 2.0 per 10,000 person-years.

The value of colorectal cancer (CRC) screening program in a population with a limited participation rate is debated. This study assesses the real-life performances of different screening tests in a population benefiting from an organized program and included in a cancer registry.

Patients who participated in at least one screening campaign between 2004 and 2016 were included. Four screening procedures were used: Hemoccult II, Magstream, Hemoccult and Magstream combined, and OC Sensor. Data were crossed with the Digestive Cancer Registry of Calvados to detect CRCs diagnosed during this period. The main outcomes were CRC detection and the incidence rate of interval cancers.

Screening consisted of 325,083 tests in 134,498 patients. Of the 2580 CRCs detected in patients aged 50–74, 534 (20.7 %) were screen-detected. OC Sensor had the highest sensitivity for CRC detection (83.7 %, 95 % CI [76.8–89.1 %]) and the lowest interval cancer rate (2.0 per 10,000 person-years, 95 % CI [1.4–2.7]) compared with other screening tests, excluding combinations. The overall participation rate was 28.9 %.

Real-life differences in performance between different screening tests exist, and OC Sensor appears to be the best. The low participation rate suggests that the rate of screen-detected CRC could be higher.

Faecal Immunochemical test

Gaïac Faecal Occult Blood Test

Predictive Positive Value

Number Needed to Screen

Number Needed to Scope

Sensitivity

Interval cancers

OC Sensor

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