Colorectal cancer: sigmoidoscopy screening may last 15 years

  • Jodal HC & al.
  • BMJ Open
  • 02/10/2019

  • Craig Hicks
  • Univadis Clinical Summaries
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Takeaway

  • Patients screened with sigmoidoscopy are less likely to develop colorectal cancer within 15 years than unscreened patients.

Why this matters

  • Most guidelines recommend rescreening after 5-10 years; it may be safe to extend this interval to 15 years, say researchers.

Study design

  • Researchers conducted a network meta-analysis of 12 randomized trials comparing colorectal cancer screening using guaiac fecal occult blood test (gFOBT), fecal immunochemical test (FIT), sigmoidoscopy, or colonoscopy in healthy patients aged 50-79 years.
  • Funding: Norwegian Research Council.

Key results

  • On the basis of high-certainty evidence, patients screened with sigmoidoscopy were slightly less likely to be diagnosed with or die from colorectal cancer than those with no screening (relative risk [RR], 0.76 [95% CI, 0.70-0.83] and RR, 0.74 [95% CI, 0.69-0.80], respectively).
  • Annual and biennial gFOBT screening had little or no association with colorectal cancer incidence, but it was linked to slightly reduced mortality (annual: RR, 0.69 [95% CI, 0.56-0.86]; biennial: RR, 0.88 [95% CI, 0.82-0.93]).
  • Moderate-certainty evidence showed greater effects in men than women for incidence (women: RR, 0.86 [95% CI, 0.81-0.92]; men: RR, 0.75 [95% CI, 0.71-0.79]) and mortality (women: RR, 0.85 [95% CI, 0.71-0.96]; men: RR, 0.67 [95% CI, 0.61-0.75]).

Limitations

  • Trials did not provide data on harms and burdens of screening.