AIM: To estimate the effectiveness of colorectal cancer screening with faecal occult blood testing (FOBT), flexible sigmoidoscopy (FS), and combinations of FOBT and FS in preventing colorectal cancer (CRC) deaths. METHOD: A systematic review was conducted examining randomised controlled trials (RCTs) published between 1997 and 2004 inclusive. A systematic search of Medline, Embase, Current Contents, and the Cochrane Library was undertaken. Studies that evaluated screening with FOBT, FS or combinations of FOBT and FS, were appraised. A meta-analysis of population-based trials of FOBT was conducted. RESULTS: Four RCTs were identified that examined FOBT screening. The three trials that investigated guaiac-based FOBT found CRC mortality was reduced in the screening group. In the two population-based trials, the pooled relative risk was 0.86 (95%CI 0.79-0.93). A fourth RCT was identified, with shorter term follow-up, which considered FOBT screening combined with FS compared with FOBT alone. No significant reduction in CRC mortality was reported in this trial. CONCLUSION: There is high-quality evidence showing that guaiac-based FOBT screening reduces mortality from CRC. No such evidence exists for screening with FS either alone, or in combination with FOBT, but this should be re-evaluated once data become available from four large ongoing trials.
AIM: To estimate the effectiveness of colorectal cancer screening with faecal occult blood testing (FOBT), flexible sigmoidoscopy (FS), and combinations of FOBT and FS in preventing colorectal cancer (CRC) deaths. METHOD: A systematic review was conducted examining randomised controlled trials (RCTs) published between 1997 and 2004 inclusive. A systematic search of Medline, Embase, Current Contents, and the Cochrane Library was undertaken. Studies that evaluated screening with FOBT, FS or combinations of FOBT and FS, were appraised. A meta-analysis of population-based trials of FOBT was conducted. RESULTS: Four RCTs were identified that examined FOBT screening. The three trials that investigated guaiac-based FOBT found CRC mortality was reduced in the screening group. In the two population-based trials, the pooled relative risk was 0.86 (95%CI 0.79-0.93). A fourth RCT was identified, with shorter term follow-up, which considered FOBT screening combined with FS compared with FOBT alone. No significant reduction in CRC mortality was reported in this trial. CONCLUSION: There is high-quality evidence showing that guaiac-based FOBT screening reduces mortality from CRC. No such evidence exists for screening with FS either alone, or in combination with FOBT, but this should be re-evaluated once data become available from four large ongoing trials.
Authors: Paul Ritvo; Ronald E Myers; Lawrence Paszat; Mardie Serenity; Daniel F Perez; Linda Rabeneck Journal: BMC Public Health Date: 2013-05-24 Impact factor: 3.295
Authors: Mette Bach Larsen; Ellen M Mikkelsen; Morten Rasmussen; Lennart Friis-Hansen; Anders U Ovesen; Hans Bjarke Rahr; Berit Andersen Journal: Clin Epidemiol Date: 2017-06-27 Impact factor: 4.790
Authors: Malgorzata A Komor; Linda Jw Bosch; Veerle Mh Coupé; Christian Rausch; Thang V Pham; Sander R Piersma; Sandra Mongera; Chris Jj Mulder; Evelien Dekker; Ernst J Kuipers; Mark A van de Wiel; Beatriz Carvalho; Remond Ja Fijneman; Connie R Jimenez; Gerrit A Meijer; Meike de Wit Journal: J Pathol Date: 2020-01-13 Impact factor: 7.996