A Swedish prospective cohort study found that participation in a population-based stool screening program was associated with a 43% reduction in colorectal cancer (CRC) mortality. The study included more than 375,000 adults aged 60–69 years who were either invited to participate in fecal occult blood test (FOBT) screening between 2008 and 2012 or assigned to a comparison group.
After adjusting for screening exposure and contamination in the control group, researchers found that receiving an invitation to screening was associated with a 26% reduction in CRC mortality over 14 years. The estimated reduction increased to 43% among individuals who actually participated in screening. The analysis builds on an earlier 2024 study and uses updated methods to account for individuals in the control group who later received screening invitations, as well as deaths occurring outside the relevant screening period.
The findings reinforce the importance of screening participation, not just availability. Researchers emphasized that simplifying testing and reducing barriers to completing stool-based screening could improve population-level outcomes.