Experience in changing fecal occult blood test from qualitative method to quantitative method for controlled colorectal cancer screening in Hamamatsu City

<p>In the countermeasure-type colorectal cancer screening program in Hamamatsu City, the Hamamatsu Medical Association, which is entrusted with the screening program, launched the Colorectal Cancer Screening Committee in 2019 and began accuracy management. As part of this effort, we analyzed data from 2015 to 2020 and conducted surveys of facilities that perform fecal occult blood tests and testing companies that received orders. It was found that the recall rate ranged from 7.4 to 8.3%, and the rate of responders for recall ranged from 53 to 63%, neither of which reached the allowable values. Further, the recall rate was highly variable among institutions, with the main reason for this being that the cut-off value of fecal occult blood was not uniform, with a wide variation of 50 to 150 ng/ml. Therefore, we changed the description of fecal occult blood test results on colorectal cancer screening forms from the conventional qualitative values to quantitative values, unified the cut-off value to 130 ng/ml, and implemented the changes in April 2022. As a result of a 1-year study, it was found that the recall rate was 6.0%, which was below the acceptable value of 7.0% for the first time, confirming that the changes were effective. To improve the proportion of responders for recall examination, the new screening form includes measures such as adding a column to confirm the intention to undergo colonoscopy when a patient is found to require a checkup and asking the examinee to check the box. The use of this new screening form is expected to facilitate appropriate colorectal cancer screening operations in the future.</p>