Screening for colorectal cancer using the faecal occult blood test, Hemoccult.

Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Research Abstract Details 

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Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Abstract Text:

BACKGROUND: Colorectal cancer is a leading cause of morbidity and mortality, especially in the Western world. The human and financial costs of this disease have prompted considerable research efforts to evaluate the ability of screening tests to detect the cancer at an early curable stage. Tests that have been considered for population screening include variants of the faecal occult blood test, flexible sigmoidoscopy and colonoscopy. Reducing mortality from colorectal cancer (CRC) may be achieved by the introduction of population-based screening programmes. OBJECTIVES: To determine whether screening for colorectal cancer using the faecal occult blood test (guaiac or immunochemical) reduces colorectal cancer mortality and to consider the benefits, harms and potential consequences of screening. SEARCH STRATEGY: Published and unpublished data for this review were identified by: Reviewing studies included in the previous Cochrane review; Searching several electronic databases (Cochrane Library, Medline, Embase, CINAHL, PsychInfo, Amed, SIGLE, HMIC); and Writing to the principal investigators of potentially eligible trials. SELECTION CRITERIA: We included in this review all randomised trials of screening for colorectal cancer that compared faecal occult blood test (guaiac or immunochemical) on more than one occasion with no screening and reported colorectal cancer mortality. DATA COLLECTION AND ANALYSIS: Data from the eligible trials were independently extracted by two reviewers. The primary data analysis was performed using the group participants were originally randomised to ('intention to screen'), whether or not they attended screening; a secondary analysis adjusted for non-attendence. We calculated the relative risks and risk differences for each trial, and then overall, using fixed and random effects models (including testing for heterogeneity of effects). We identified nine articles concerning four randomised controlled trials and two controlled trials involving over 320,000 participants with follow-up ranging from 8 to 18 years. MAIN RESULTS: Combined results from the 4 eligible randomised controlled trials shows that participants allocated to screening had a 16% reduction in the relative risk of colorectal cancer mortality (RR 0.84, CI: 0.78-0.90). In the 3 studies that used biennial screening (Funen, Minnesota, Nottingham) there was a 15% relative risk reduction (RR 0.85, CI: 0.78-0.92) in colorectal cancer mortality. When adjusted for screening attendance in the individual studies, there was a 25% relative risk reduction (RR 0.75, CI: 0.66 - 0.84) for those attending at least one round of screening using the faecal occult blood test. AUTHORS' CONCLUSIONS: Benefits of screening include a modest reduction in colorectal cancer mortality, a possible reduction in cancer incidence through the detection and removal of colorectal adenomas, and potentially, the less invasive surgery that earlier treatment of colorectal cancers may involve. Harmful effects of screening include the psycho-social consequences of receiving a false-positive result, the potentially significant complications of colonoscopy or a false-negative result, the possibility of overdiagnosis (leading to unnecessary investigations or treatment) and the complications associated with treatment.

Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Publishing Authors By Initials

For similar investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: clinical trials as topic: controlled clinical trials as topic: randomized controlled trials as topic research abstracts see: investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: clinical trials as topic: controlled clinical trials as topic: randomized controlled trials as topic research

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Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Journal Published:

PUBLICATION TYPE: Review

Journal: Cochrane database of systematic reviews (Online)

VOLUME:

Page Numbers: CD001216

Journal Abbreviation:

ISSN: 1469-493X

DAY: 24

MONTH: 01

YEAR: 2007

Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Information

Number of References: 46

LANGUAGE: eng

NlmUniqueID: 100909747

Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Keywords Mesh Terms:

KEYWORDS: Randomized Controlled Trials as Topic

MESH TERMS: prevention & control

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Grant and Affiliation Information for Screening for colorectal cancer using the faecal occult blood test, Hemoccult.

AFFILIATION: Unviersity of Oxford, Department of Primary Health Care, Oxford, UK. paul.hewitson@dphpc.ox.ac.uk

Country: England

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MEDLINETA: Cochrane Database Syst Rev

REFSOURCE: Cochrane Database Syst Rev. 2000;(2):CD0

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