Adherence to follow-up after a positive fecal occult blood test in an organized colorectal cancer screening program in Korea, 2004-2008

J Gastroenterol Hepatol. 2012 Jun;27(6):1070-7. doi: 10.1111/j.1440-1746.2011.06944.x.


Background and aim: To investigate the participation rates, positivity rates, and follow-up rates from 2004 to 2008 in an organized colorectal cancer (CRC) screening program using a fecal occult blood test (FOBT) in Korea.

Methods: The study population was men and women aged 50 years or older who were invited to participate in the National Cancer Screening Program for CRC between 1 January 2004 and 31 December 2008. We collected the FOBT results and follow-up information for the FOBT positives.

Results: Participation rates increased steadily each year from 10.5% in 2004 to 21.1% in 2008. Between 2004 and 2008, FOBT positivity rates declined from 8.0% to 6.8%. Among the FOBT-positives, 61.3% of participants underwent either colonoscopy or double contrast barium enema (DCBE) in 2004, and this rate decreased to 38.6% in 2008. Age, health insurance type, and screening history were associated with adherence to follow-up test after a positive FOBT. With regard to follow-up tests, colonoscopy rates increased from 17.9% in 2004 to 27.6% in 2008, while DCBE decreased from 43.4% in 2004 to 11.0% in 2008. Colonoscopy was significantly more likely to be chosen as a follow-up test by men, participants aged 50-59 years, and National Health Insurance beneficiaries.

Conclusion: These findings suggest that targeting participants for follow-up, based on age and previous screening history, could be a good way to improve the follow-up rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Barium Sulfate
  • Colonoscopy / statistics & numerical data
  • Colonoscopy / trends
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / psychology
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / psychology
  • Early Detection of Cancer / trends*
  • Enema / statistics & numerical data
  • Enema / trends
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Occult Blood*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Compliance / statistics & numerical data*
  • Program Evaluation
  • Republic of Korea / epidemiology


  • Barium Sulfate