The cumulative false-positive rate in colorectal cancer screening: A Markov analysis

Ulrike Haug, Veerle M.H. Coupé

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)


Background: Faecal occult blood testing is widely used in colorectal cancer screening. However, there is little empirical long-term evidence on the accumulation of false-positive test results over several screening rounds. We aimed to systematically explore and quantify the cumulative false-positive rate for various scenarios of colorectal cancer screening. Methods: Using a Markov analysis, we estimated the lifetime cumulative number of false-positive test results (cumFP) per 100 000 50-year-old persons. We varied the screening interval and the specificity of a single screening test and the starting age of screening. Results: For a test with a specificity of 98% used from 50 to 74 years, the cumFP at age 74 was 26 260 (1-year interval), 15 102 (2-year interval), and 10 819 (3-year interval), respectively. For a test with a specificity of, respectively, 95 and 92% used at a 2-year interval, the cumFP at age 74 was 2.2 times and 3.0 times higher as compared to a test with a specificity of 98%. The cumFP at age 74 was 18% lower for screening persons aged 54-74 years vs. 50-74 years. Conclusion: Our findings quantitatively illustrate the large variation of the cumFP in colorectal cancer screening between screening strategies, which is relevant to informed decision making and adequate resource planning.

Original languageEnglish
Pages (from-to)575-580
Number of pages6
JournalEuropean Journal of Gastroenterology and Hepatology
Issue number5
Publication statusPublished - 1 May 2020


  • colorectal cancer
  • false-positive
  • screening

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