Screening for Colorectal Cancer: A Systematic Review and Meta-Analysis

Fitzpatrick‐Lewis, Donna; Ali, Muhammad Usman; Warren, Rachel; Kenny, Meghan; Sherifali, Diana; Raina, Parminder

doi:10.1016/j.clcc.2016.03.003

Cited by 116 publications

(123 citation statements)

References 55 publications

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“…Finally, a search of the web-based grey literature from 2005 to 2015 identified Canadian information to inform contextual questions. 22 The analytic framework for the review is available in Appendix 1 (see www.cmaj.ca/lookup/ suppl/doi:10.1503/cmaj.170118/-/DC1). The protocol 23 and systematic review 22 were reviewed by content experts and health care stakeholders.…”

Section: Methodsmentioning

confidence: 99%

“…19 The recommendations are based on a systematic review, conducted by the Evidence Review and Synthesis Centre at McMaster University (Hamilton, Ontario), which updated the 2014 review by the US Preventive Services Task Force 20 on outcomes of AAA screening with ultrasonography. 21,22 Outcomes addressed by the systematic review included AAA-related and all-cause mortality, AAA rupture, 30-day mortality following emergency and elective procedures, and the impact of screening on frequency of emergency and elective procedures. The peerreviewed literature search was conducted in MEDLINE, Embase, PubMed and CENTRAL from January 2013 to April 2015 with additional review of topic lists of relevant systematic reviews.…”

Section: Methodsmentioning

confidence: 99%

“…One of these RCTs included women, 18 and these findings are presented in the section on screening in women. The 12.8-year follow-up of the trial from Western Australia 15 was published in 2016 34 after the systematic review 22 for the task force was completed; the evidence base used by the task force was updated to include these findings before the recommendations were drafted. 24 …”

Section: Men Aged 65 Years and Oldermentioning

confidence: 99%

“…Four population-based RCTs [15][16][17][18] evaluated outcomes of one-time AAA screening of asymptomatic men aged 65 years or older with ultrasonography compared with usual care 21,22 (Table 1). One of these RCTs included women, 18 and these findings are presented in the section on screening in women.…”

Section: Men Aged 65 Years and Oldermentioning

confidence: 99%

“…21,25 Four studies were identified that evaluated the effect of AAA screening on quality of life (very low-quality evidence) among men aged 65 years and older. 22 Three observational studies used standardized measures for quality of life and did not find statistically significant differences between patients who screened positive compared with the control group. 22 Postscreening data from the Multicentre Aneurysm Screening Study (MASS) trial also reported no difference in quality-of-life measures between screen-positive and control groups.…”

mentioning

confidence: 99%

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Recommendations on screening for abdominal aortic aneurysm in primary care

2017

CMAJ

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KEY POINTS• Pooled analyses from four population-based RCTs with men older than 65 years show that one-time screening with ultrasonography for AAA reduces the risk of aneurysm-related death, rupture and emergency repair.• Screening leads to identification of aneurysms that would not dilate or rupture, and increases the likelihood of elective repair procedures for these patients.• A weak recommendation in favour of screening suggests the importance of shared decision-making with the primary care provider and patient, with discussion of patient preferences for screening.• The prevalence of AAA in screened populations has declined since the RCTs were conducted, reducing the absolute benefit of screening.• Women have much lower rates of AAA than men, and there is no direct evidence that screening women has a positive impact on their health.• Evidence on the impact of AAA screening on men older than 80 years of age is indirect, meaning any potential benefit is uncertain. CPD

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Men Aged 65 Years and Oldermentioning

confidence: 99%

Section: Men Aged 65 Years and Oldermentioning

confidence: 99%

mentioning

confidence: 99%

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Recommendations on screening for abdominal aortic aneurysm in primary care

2017

CMAJ

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Sex differences in faecal occult blood test screening for colorectal cancer

Koskenvuo

Malila

Pitkäniemi

et al. 2018

British Journal of Surgery

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Background This analysis of patients in a randomized population‐based health services study was done to determine the effects of faecal occult blood test (FOBT) screening of colorectal cancer (CRC) in outcomes beyond mortality, and to obtain explanations for potential sex differences in screening effectiveness. Methods In the Finnish FOBT screening programme (2004–2011), people aged 60–69 years were randomized into the screening and control arms. Differences in incidence, symptoms, tumour location, TNM categories, non‐vital outcomes and survival in the screening and control arms were analysed. Results From 321 311 individuals randomized, 743 patients with screening‐detected tumours and 617 control patients with CRC were analysed. CRC was less common in women than in men (0·34 versus 0·50 per cent; risk ratio (RR) 0·82, 95 per cent c.i. 0·74 to 0·91) and women were less often asymptomatic (16·7 versus 22·0 per cent; RR 0·76, 0·61 to 0·93). Women more often had right‐sided tumours (32·0 versus 21·3 per cent; RR 1·51, 1·26 to 1·80). Among men with left‐sided tumours, those in the screening arm had lower N (RR 1·23, 1·02 to 1·48) and M (RR 1·57, 1·14 to 2·17) categories, as well as a higher overall survival rate than those in the control arm. Furthermore among men with left‐sided tumours, non‐radical resections (26·2 versus 15·7 per cent; RR 1·67, 1·22 to 2·30) and postoperative chemotherapy sessions (61·6 versus 48·2 per cent; RR 1·28, 1·10 to 1·48) were more frequent in the control arm. Similar benefits of screening were not detected in men with right‐sided tumours or in women. Conclusion Biennial FOBT screening seems to be effective in terms of improving several different outcomes in men, but not in women. Differences in incidence, symptoms and tumour location may explain the differences in screening efficacy between sexes.

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Translating genomic risk into an early detection strategy for sarcoma

Ballinger

Pinese

Thomas

2018

Genes Chromosomes & Cancer

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Sarcomas have a strong genetic etiology, and the study of families affected by sarcomas has informed much of what we now understand of modern cancer biology. The recent emergence of powerful genetic technologies has led to astonishing reductions in costs and increased throughput. In the clinic, these technologies are revealing a previously unappreciated and rich landscape of genetic cancer risk. In addition to both known and new cancer risk mutations, genomic tools are cataloguing complex and polygenic risk patterns, collectively explaining between 15–25% of apparently sporadic sarcoma cases. The impact on clinical management is exemplified by Li‐Fraumeni Syndrome, the most penetrant sarcoma syndrome. Whole body magnetic resonance imaging can identify surgically resectable cancers in up to one in ten individuals with Li‐Fraumeni Syndrome. Taken together, parallel developments in genomics, therapeutics and imaging technologies will drive closer engagement between genetics and multidisciplinary care of the sarcoma patient in the 21st century.

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Screening for Colorectal Cancer: A Systematic Review and Meta-Analysis

Cited by 116 publications

References 55 publications

Recommendations on screening for abdominal aortic aneurysm in primary care

Recommendations on screening for abdominal aortic aneurysm in primary care

Sex differences in faecal occult blood test screening for colorectal cancer

Translating genomic risk into an early detection strategy for sarcoma

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