{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T17:43:31Z","timestamp":1780681411878,"version":"3.54.1"},"reference-count":24,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[1999,3,30]]},"published-print":{"date-parts":[[1999,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>AIMS<\/jats:title>\n                    <jats:p>To determine the harm that ensues from faecal occult blood (FOB) screening for colorectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>150\u2009251 people were randomly allocated either to receive biennial Haemoccult FOB tests (n =75\u2009253) or not to be contacted (n=74\u2009998). Study group patients returning positive tests were offered colonic investigation; 1774 underwent complete investigation of the colon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>There was no significant difference in the stage at presentation of interval versus control group cancers. Survival in the interval cancer group was significantly prolonged compared with the control group. Sensitivity for colonoscopy or flexible sigmoidoscopy and double contrast barium enema (DCBE) was 96.7%. There were no complications of DCBE but seven (0.5%) complications of colonoscopy, of which six required surgical intervention. There were no colonoscopy related deaths. No patients without colorectal cancer died within 30 days of colonic investigation. Five patients died within 30 days of surgery for screen detected colorectal neoplasia and a further two died without having surgery. Six patients died after 30 days but within two years of surgery for screen detected benign adenomas or stage A cancers; in all cases the cause of death was not related to colorectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>There was investigation related morbidity but no mortality and little to support overdiagnosis bias. The group returning falsely negative tests had a better outcome compared with the whole control group. There is a negative side to any screening programme but mortality reduction in this and other trials suggests that a national programme of colorectal cancer screening should be given consideration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/gut.45.4.588","type":"journal-article","created":{"date-parts":[[2010,6,30]],"date-time":"2010-06-30T12:46:12Z","timestamp":1277901972000},"page":"588-592","source":"Crossref","is-referenced-by-count":75,"title":["The risks of screening: data from the Nottingham randomised controlled trial of faecal occult blood screening for colorectal cancer"],"prefix":"10.1136","volume":"45","author":[{"given":"M H E","family":"Robinson","sequence":"first","affiliation":[{"name":"aDepartment of Surgery, City Hospital, NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK, \n\nbDepartment of Surgery, Queens Medical Centre, Nottingham, UK, \n\ncCancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J D","family":"Hardcastle","sequence":"additional","affiliation":[{"name":"aDepartment of Surgery, City Hospital, NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK, \n\nbDepartment of Surgery, Queens Medical Centre, Nottingham, UK, \n\ncCancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S M","family":"Moss","sequence":"additional","affiliation":[{"name":"aDepartment of Surgery, City Hospital, NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK, \n\nbDepartment of Surgery, Queens Medical Centre, Nottingham, UK, \n\ncCancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S S","family":"Amar","sequence":"additional","affiliation":[{"name":"aDepartment of Surgery, City Hospital, NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK, \n\nbDepartment of Surgery, Queens Medical Centre, Nottingham, UK, \n\ncCancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J O","family":"Chamberlain","sequence":"additional","affiliation":[{"name":"aDepartment of Surgery, City Hospital, NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK, \n\nbDepartment of Surgery, Queens Medical Centre, Nottingham, UK, \n\ncCancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N C M","family":"Armitage","sequence":"additional","affiliation":[{"name":"aDepartment of Surgery, City Hospital, NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK, \n\nbDepartment of Surgery, Queens Medical Centre, Nottingham, UK, \n\ncCancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J H","family":"Scholefield","sequence":"additional","affiliation":[{"name":"aDepartment of Surgery, City Hospital, NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK, \n\nbDepartment of Surgery, Queens Medical Centre, Nottingham, UK, \n\ncCancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C M","family":"Mangham","sequence":"additional","affiliation":[{"name":"aDepartment of Surgery, City Hospital, NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK, \n\nbDepartment of Surgery, Queens Medical Centre, Nottingham, UK, \n\ncCancer Screening Evaluation Unit, Institute of Cancer Research, Sutton, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1999,10,1]]},"reference":[{"key":"2025121304372413000_45.4.588.1","unstructured":"Office of Population Censuses and Surveys (1995) Mortality statistics by cause. England and Wales 1992. Series DH2. No. 20. (HMSO, London)."},{"key":"2025121304372413000_45.4.588.2","first-page":"119","article-title":"The results of 1115 patients with colorectal cancer treated over an 8-year period in a single hospital.","volume":"11","author":"Stower","year":"1985","journal-title":"Eur J Surg Oncol"},{"key":"2025121304372413000_45.4.588.3","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/BF02553944","article-title":"Survival of 727 patients with single carcinomas of the large bowel.","volume":"27","author":"Umpleby","year":"1984","journal-title":"Dis Colon Rectum"},{"key":"2025121304372413000_45.4.588.4","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800841224"},{"key":"2025121304372413000_45.4.588.5","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.7326\/0003-4819-118-1-199301010-00001","article-title":"Effect of fecal occult blood testing on mortality from colorectal cancer: a case-control study.","volume":"118","author":"Selby","year":"1993","journal-title":"Ann Intern Med"},{"key":"2025121304372413000_45.4.588.6","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910610406"},{"key":"2025121304372413000_45.4.588.7","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1097\/00008469-199305000-00005","article-title":"Effectiveness of colorectal cancer screening: results from a population-based case-control evaluation in Saarland, Germany.","volume":"2","author":"Wahrendorf","year":"1993","journal-title":"Eur J Cancer Prev"},{"key":"2025121304372413000_45.4.588.8","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1177\/096914139500200206","article-title":"A case-control study to evaluate efficacy of screening faecal occult blood.","volume":"2","author":"Lazovich","year":"1995","journal-title":"J Med Screen"},{"key":"2025121304372413000_45.4.588.9","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(19971009)73:2<208::AID-IJC8>3.0.CO;2-#"},{"key":"2025121304372413000_45.4.588.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199305133281901"},{"key":"2025121304372413000_45.4.588.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)03386-7"},{"key":"2025121304372413000_45.4.588.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)03430-7"},{"key":"2025121304372413000_45.4.588.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7158.559"},{"key":"2025121304372413000_45.4.588.14","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1038\/bjc.1993.462","article-title":"Screening and the costs of treating colorectal cancer.","volume":"68","author":"Whynes","year":"1993","journal-title":"Br J Cancer"},{"key":"2025121304372413000_45.4.588.15","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1136\/bmj.299.6698.527","article-title":"Psychological costs of screening.","volume":"299","author":"Marteau","year":"1989","journal-title":"BMJ"},{"key":"2025121304372413000_45.4.588.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8553(05)70282-X"},{"key":"2025121304372413000_45.4.588.17","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196709000-00010"},{"key":"2025121304372413000_45.4.588.18","doi-asserted-by":"publisher","DOI":"10.1002\/path.1700350303"},{"key":"2025121304372413000_45.4.588.19","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-1050(199802)7:1<21::AID-HEC306>3.0.CO;2-9"},{"key":"2025121304372413000_45.4.588.20","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(97)70213-0"},{"key":"2025121304372413000_45.4.588.21","doi-asserted-by":"publisher","DOI":"10.1136\/gut.24.5.376"},{"key":"2025121304372413000_45.4.588.22","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1136\/bmj.317.7158.558a","article-title":"Moves to end cervical screening failures in England.","volume":"317","author":"Warden","year":"1998","journal-title":"BMJ"},{"key":"2025121304372413000_45.4.588.23","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v110.pm8536869"},{"key":"2025121304372413000_45.4.588.24","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.317.7154.307"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.45.4.588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T12:37:32Z","timestamp":1765629452000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.45.4.588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,10,1]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1999,10,1]]},"published-print":{"date-parts":[[1999,10,1]]}},"alternative-id":["10.1136\/gut.45.4.588"],"URL":"https:\/\/doi.org\/10.1136\/gut.45.4.588","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,10,1]]}}}