Reduced incidence and mortality from colorectal cancer with flexible-sigmoidoscopy screening: A meta-analysis
AIM:To conduct a systematic review and meta-analysis of published population-based randomized controlled trials(RCTs).METHODS:RCTs evaluating the difference in mortality and incidence of colorectal cancer(CRC)between a screening flexible sigmoidoscopy(FS)group and control group(not assigned to scree...
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Published in | World journal of gastroenterology : WJG Vol. 20; no. 48; pp. 18466 - 18476 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Baishideng Publishing Group Inc
28.12.2014
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Subjects | |
Online Access | Get full text |
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Summary: | AIM:To conduct a systematic review and meta-analysis of published population-based randomized controlled trials(RCTs).METHODS:RCTs evaluating the difference in mortality and incidence of colorectal cancer(CRC)between a screening flexible sigmoidoscopy(FS)group and control group(not assigned to screening FS)with a minimum 5 years median follow-up were identified by a search of MEDLINE and EMBASE databases and the Cochrane Central Register for Controlled Trials through August 2013.Random effects model was used for meta-analysis.RESULTS:Four RCTs with a total of 165659 patientsin the FS group and 249707 patients in the control group were included in meta-analysis.Intention-totreat analysis showed that there was a 22%risk reduction in total incidence of CRC(RR=0.78,95%CI:0.74-0.83),31%in distal CRC incidence(RR=0.69,95%CI:0.63-0.75),and 9%in proximal CRC incidence(RR=0.91,95%CI:0.83-0.99).Those who underwent screening FS were 18%less likely to be diagnosed with advanced CRC(OR=0.82,95%CI:0.71-0.94).There was a 28%risk reduction in overall CRC mortality(RR=0.72,95%CI:0.65-0.80)and 43%in distal CRC mortality(RR=0.57,95%CI:0.45-0.72).CONCLUSION:This meta-analysis suggests that screening FS can reduce the incidence of proximal and distal CRC and mortality from distal CRC along with reduction in diagnosis of advanced CRC. |
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Bibliography: | Jennifer Shroff;Nirav Thosani;Sachin Batra;Harminder Singh;Sushovan Guha;Division of Gastroenterology, Hepatology and Nutrition,The University of Texas Medical School at Houston, 77030 TX,United States;Departments of Internal Medicine and Community Health Sciences and IBD Clinical and Research Centre, University of Manitoba, Winnipeg MB R3T 2N, Canada ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-Review-4 content type line 23 ObjectType-Undefined-3 Telephone: +1-713-5006677 Fax: +1-713-5006699 Author contributions: Shroff J contributed to acquisition of data, analysis and interpretation of data, and drafting of manuscript; Thosani N and Guha S contributed to concept and study design, acquisition of data, analysis and interpretation of data, statistical analysis, and drafting of manuscript; Batra S and Singh H contributed to acquisition of data, analysis and interpretation of data, statistical analysis, and drafting of manuscript; and Guha S contributed to drafting of manuscript, critical revision of manuscript for important intellectual content, statistical analysis, administrative, technical, or material support and supervision. Correspondence to: Sushovan Guha, MD, PhD, Division of Gastroenterology, Hepatology, and Nutrition, MSB 4.234, 6431 Fannin Street, Houston, TX 77030, United States. sushovan.guha@uth.tmc.edu |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v20.i48.18466 |