{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:27:34Z","timestamp":1790206054349,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,1,27]],"date-time":"2021-01-27T00:00:00Z","timestamp":1611705600000},"content-version":"vor","delay-in-days":700,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010711","name":"Cancer Foundation Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010711","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Helsinki University Hospital research funds"},{"name":"Mary and Georg Ehrnrooth's Foundation"},{"DOI":"10.13039\/100019208","name":"Vatsatautien Tutkimuss\u00e4\u00e4ti\u00f6","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100019208","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This analysis of patients in a randomized population-based health services study was done to determine the effects of faecal occult blood test (FOBT) screening of colorectal cancer (CRC) in outcomes beyond mortality, and to obtain explanations for potential sex differences in screening effectiveness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In the Finnish FOBT screening programme (2004\u20132011), people aged 60\u201369 years were randomized into the screening and control arms. Differences in incidence, symptoms, tumour location, TNM categories, non-vital outcomes and survival in the screening and control arms were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 321 311 individuals randomized, 743 patients with screening-detected tumours and 617 control patients with CRC were analysed. CRC was less common in women than in men (0\u00b734 versus 0\u00b750 per cent; risk ratio (RR) 0\u00b782, 95 per cent c.i. 0\u00b774 to 0\u00b791) and women were less often asymptomatic (16\u00b77 versus 22\u00b70 per cent; RR 0\u00b776, 0\u00b761 to 0\u00b793). Women more often had right-sided tumours (32\u00b70 versus 21\u00b73 per cent; RR 1\u00b751, 1\u00b726 to 1\u00b780). Among men with left-sided tumours, those in the screening arm had lower N (RR 1\u00b723, 1\u00b702 to 1\u00b748) and M (RR 1\u00b757, 1\u00b714 to 2\u00b717) categories, as well as a higher overall survival rate than those in the control arm. Furthermore among men with left-sided tumours, non-radical resections (26\u00b72 versus 15\u00b77 per cent; RR 1\u00b767, 1\u00b722 to 2\u00b730) and postoperative chemotherapy sessions (61\u00b76 versus 48\u00b72 per cent; RR 1\u00b728, 1\u00b710 to 1\u00b748) were more frequent in the control arm. Similar benefits of screening were not detected in men with right-sided tumours or in women.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Biennial FOBT screening seems to be effective in terms of improving several different outcomes in men, but not in women. Differences in incidence, symptoms and tumour location may explain the differences in screening efficacy between sexes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.11011","type":"journal-article","created":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T13:44:17Z","timestamp":1542807857000},"page":"436-447","source":"Crossref","is-referenced-by-count":21,"title":["Sex differences in faecal occult blood test screening for colorectal cancer"],"prefix":"10.1093","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8335-7942","authenticated-orcid":false,"given":"L","family":"Koskenvuo","sequence":"first","affiliation":[{"name":"Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Malila","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Pitk\u00e4niemi","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research , Helsinki,","place":["Finland"]},{"name":"Department of Public Health, Faculty of Medicine, University of Helsinki , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Miettinen","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Heikkinen","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5394-4169","authenticated-orcid":false,"given":"V","family":"Sallinen","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki , Helsinki,","place":["Finland"]},{"name":"Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki , Helsinki,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,1]]},"reference":[{"key":"2024092914165660200_bjs11011-bib-0001","doi-asserted-by":"crossref","first-page":"E359","DOI":"10.1002\/ijc.29210","article-title":"Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012","volume":"136","author":"Ferlay","year":"2015","journal-title":"Int J Cancer"},{"key":"2024092914165660200_bjs11011-bib-0002","doi-asserted-by":"crossref","first-page":"795","DOI":"10.3109\/00365521.2012.672589","article-title":"Association of symptoms of colon cancer patients with tumor location and TNM tumor stage","volume":"47","author":"Alexiusdottir","year":"2012","journal-title":"Scand J Gastroenterol"},{"key":"2024092914165660200_bjs11011-bib-0003","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1056\/NEJMcp1512286","article-title":"Screening for colorectal neoplasia","volume":"376","author":"Inadomi","year":"2017","journal-title":"N Engl J Med"},{"key":"2024092914165660200_bjs11011-bib-0004","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1016\/S0140-6736(96)03386-7","article-title":"Randomised controlled trial of faecal-occult-blood screening for colorectal cancer","volume":"348","author":"Hardcastle","year":"1996","journal-title":"Lancet"},{"key":"2024092914165660200_bjs11011-bib-0005","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1016\/S0140-6736(96)03430-7","article-title":"Randomised study of screening for colorectal cancer with faecal-occult-blood test","volume":"348","author":"Kronborg","year":"1996","journal-title":"Lancet"},{"key":"2024092914165660200_bjs11011-bib-0006","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1002\/bjs.6136","article-title":"Survival benefit in a randomized clinical trial of faecal occult blood screening for colorectal cancer","volume":"95","author":"Lindholm","year":"2008","journal-title":"Br J Surg"},{"key":"2024092914165660200_bjs11011-bib-0007","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1056\/NEJM199305133281901","article-title":"Reducing mortality from colorectal cancer by screening for fecal occult blood. 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