Evidence for colorectal cancer screening

被引:62
作者
Bretthauer, Michael [1 ]
机构
[1] Oslo Univ Hosp, Canc Registry Norway, Ctr Colorectal Canc Screening, N-0304 Oslo, Norway
关键词
Colorectal cancer screening; FECAL-OCCULT-BLOOD; RANDOMIZED CONTROLLED-TRIAL; SERVICES TASK-FORCE; BASE-LINE FINDINGS; FLEXIBLE SIGMOIDOSCOPY; ADENOMA DETECTION; US; POPULATION; MORTALITY; SURVEILLANCE;
D O I
10.1016/j.bpg.2010.06.005
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The incidence of colorectal cancer (CRC) has been increasing during the past decades, and the lifetime risk for CRC in industrialised countries is about 5%. CRC is a good candidate for screening, because it is a disease with high prevalence, has recognised precursors, and early treatment is beneficial. This paper outlines the evidence for efficacy from randomised trials for the most commonly used CRC screening tests to reduce CRC incidence and mortality in the average-risk population. Four randomised trials have investigated the effect of guaiac-based fecal occult blood screening on CRC mortality, with a combined CRC mortality risk reduction of 15-17% in an intention-to-screen analysis, and 25% for those people who attended screening. Flexible sigmoidoscopy screening has been evaluated in three randomised trials. The observed reduction in CRC incidence varied between 23 and 80%, and between 27 and 67% for CRC mortality, respectively (intention-to-screen analyses) in the trials with long follow-up time. No randomised trials exist in other CRC screening tools, included colonoscopy screening. FOBT and flexible sigmoidoscopy are the two CRC screening methods which have been tested in randomised trials and shown to reduce CRC mortality. These tests can be recommended for CRC screening. (C) 2010 Elsevier Ltd. All rights reserved.
引用
收藏
页码:417 / 425
页数:9
相关论文
共 44 条
[1]   Colorectal Cancer Screening Guidelines: The Importance of Evidence and Transparency [J].
Allison, James E. .
GASTROENTEROLOGY, 2010, 138 (05) :1648-U28
[2]  
Altekruse S F., SEER CANC STAT REV 1
[3]  
[Anonymous], 1968, PUBLIC HLTH PAP, DOI DOI 10.1001/ARCHINTE.1969.00300130131020
[4]  
[Anonymous], GLOBOCAN database
[5]   Wide variation in adenoma detection rates at screening flexible sigmoidoscopy [J].
Atkin, W ;
Rogers, P ;
Cardwell, C ;
Cook, C ;
Cuzick, J ;
Wardle, J ;
Edwards, R .
GASTROENTEROLOGY, 2004, 126 (05) :1247-1256
[6]   Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial [J].
Atkin, Wendy S. ;
Edwards, Rob ;
Kralj-Hans, Ines ;
Wooldrage, Kate ;
Hart, Andrew R. ;
Northover, John M. A. ;
Parkin, D. Max ;
Wardle, Jane ;
Duffy, Stephen W. ;
Cuzick, Jack .
LANCET, 2010, 375 (9726) :1624-1633
[7]   Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial [J].
Atkin, WS ;
Cook, CF ;
Cuzick, J ;
Edwards, R ;
Northover, JMA ;
Wardle, J .
LANCET, 2002, 359 (9314) :1291-1300
[8]   Which tool is best for colorectal cancer screening? [J].
Bretthauer, Michael .
BRITISH MEDICAL JOURNAL, 2010, 340
[9]   The Capsule and Colorectal-Cancer Screening - The Crux of the Matter [J].
Bretthauer, Michael .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 361 (03) :300-301
[10]   Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement [J].
Calonge, Ned ;
Petitti, Diana B. ;
DeWitt, Thomas G. ;
Dietrich, Allen J. ;
Gregory, Kimberly D. ;
Harris, Russell ;
Isham, George ;
LeFevre, Michael L. ;
Leipzig, Roseanne M. ;
Loveland-Cherry, Carol ;
Marion, Lucy N. ;
Melnyk, Bernadette ;
Moyer, Virginia A. ;
Ockene, Judith K. ;
Sawaya, George F. ;
Yawn, Barbara P. .
ANNALS OF INTERNAL MEDICINE, 2008, 149 (09) :627-+