Scolaris Content Display Scolaris Content Display

Porównanie giętkiej sigmoidoskopii z badaniem na krew utajoną w stolcu jako badań przesiewowych dla wczesnego wykrywania raka jelita grubego u osób bezobjawowych

Appendices

Appendix 1. MEDLINE (faecal occult blood) search strategy

#1        exp Colorectal Neoplasms/

#2        exp Colonic Neoplasms/  

#3        exp Rectal Neoplasms/

#4                  ((colorectal* or CRC or colon* or bowel* or rectal or rectum or sigmoid or anal or anus) and (cancer or neoplasm* or tumor* or tumour or carcinom* or sarcom* or adenocarcinom* or adeno?carcinom* or adenom* or lesion*)).mp. 

#5        1 or 2 or 3 or 4

#6        exp Occult Blood/

#7        exp Immunochemistry/  

#8                  (faecal or fecal or feces or faeces or gFOBT or FOBT or FOB or FIT or haemoccult or hemoccult or sensa or heamoccultsensa or hemocare or hema screen or hemascreen or hemacheck or hema check or hemawipe or hema wipe or hemofec or hemofecia or fecatest or fecatwin or coloscreen or seracult or ez?detect or colocare or flexsure or hemmoquant or immocare or hemochaser or bayer detect or hemeselect or immudia or monohaem or insure or hemodia or instant?view or immocare or magstream or guaiac or occult blood or (stool adj3 occult) or (gaiac* adj2 smear*)).mp.

#9                 ((((immunochemical* adj3 (test* or screen* or diagn*)) or immunologic*) adj3 (test* or screen* or diagn*)) or enzyme or EIA or assay or RPHA or latex or agglutin* or monocl* or polyclo*).mp.  

#10      6 or 7 or 8 or 9

#11      exp Mass Screening/

#12      exp Population Surveillance/

#13                (screen* or test* or (population* adj2 surveillance) or (early adj3 detect*) or (early adj3 prevent*)).mp.

#14      11 or 12 or 13

#15      5 and 10 and 14

#16      randomized controlled trial.pt.  

#17      controlled clinical trial.pt.

#18      randomized.ab.

#19      placebo.ab.  

#20      clinical trial.sh.  

#21      randomly.ab.  

#22      trial.ti.

#23      16 or 17 or 18 or 19 or 20 or 21 or 22  

#24      humans.sh.

#25      23 and 24

#26      15 and 25

 

Appendix 2. MEDLINE (flexible sigmoidoscopy) search strategy

#1        exp Colorectal Neoplasms/

#2        exp Colonic Neoplasms/

#3        exp Rectal Neoplasms/  

#4                  ((colorectal* or CRC or colon* or bowel* or intestine* or large intestine* or rectal or rectum or sigmoid or anal or anus) and (cancer or neoplasm* or malign* or tumor* or tumour* or carcinom* or sarcom* or adenocarcinom* or adeno?carcinom* or adenom* or lesion*)).mp.

#5        1 or 2 or 3 or 4

#6        exp Endoscopy, Gastrointestinal/  

#7        exp Colonoscopy/

#8        exp Sigmoidoscopy/  

#9        exp Proctoscopy/

#10                (endoscop* or proctoscop* or colonoscop* or sigmoidoscop* or rectosigmoidoscop* or proctosigmoidoscop* or COL or SIG or FSIG or (flex* adj3 sig*)).mp.  

#11      6 or 7 or 8 or 9 or 10

#12      exp Mass Screening/

#13      exp Population Surveillance/  

#14                (screen* or test* or (population* adj2 surveillance) or (early adj3 detect*) or (early adj3 prevent*)).mp. [mp=protocol supplementary concept, rare disease supplementary concept, title, original title, abstract, name of substance word, subject heading word, unique identifier]

#15      12 or 13 or 14  

#16      5 and 11 and 15  

#17      randomized controlled trial.pt.

#18      controlled clinical trial.pt.

#19      randomized.ab.

#20      placebo.ab.  

#21      clinical trial.sh.

#22      randomly.ab.  

#23      trial.ti.

#24      17 or 18 or 19 or 20 or 21 or 22 or 23  

#25      humans.sh.

#26      24 and 25

#27      16 and 26

Appendix 3. EMBASE (faecal occult blood) search strategy

#1                 exp colorectal tumor/

#2                 exp colorectal cancer/

#3                 exp colorectal carcinoma/  

#4                 exp colorectal adenoma/  

#5                 exp colon tumor/  

#6                 exp colon cancer/

#7                 exp colon carcinoma/

#8                 exp colon adenoma/ 

#9                 exp colon adenocarcinoma/  

#10               exp rectum tumor/

#11               exp rectum cancer/  

#12               exp rectum carcinoma/

#13               exp rectum adenoma/

#14               ((colorectal* or CRC or colon or colonic or bowel* or intestine or large intestine or rectal or rectum or sigmoid or anal or anus) and (cancer or neoplasm* or malign* or tumor* or tumour or carcinom* or sarcom* or adenocarcinom* or adeno?carcinom* or adenom* or lesion*)).m_titl.

#15               1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14

#16               exp occult blood/

#17               exp feces analysis/ 

#18               exp immunochemistry/

#19               (faecal or fecal or feces or faeces or gFOBT or FOBT or FOB or FIT or haemoccult or hemoccult or sensa or heamoccultsensa or hemocare or hema screen or hemascreen or hemacheck or hema check or hemawipe or hema wipe or hemofec or hemofecia or fecatest or fecatwin or coloscreen or seracult or ez?detect or colocare or flexsure or hemmoquant or immocare or hemochaser or bayer detect or hemeselect or immudia or monohaem or insure or hemodia or instant?view or immocare or magstream or guaiac or occult blood or (stool adj3 occult) or (gaiac* adj2 smear*)).mp. 

#20               ((((immunochemical* adj3 (test* or screen* or diagn*)) or immunologic*) adj3 (test* or screen* or diagn*)) or enzyme or EIA or assay or RPHA or latex or agglutin* or monocl* or polyclo*).mp. 

#21               16 or 17 or 18 or 19 or 20

#22               exp mass screening/

#23               exp health survey/

#24               (screen* or test* or (population* adj2 surveillance) or (early adj3 detect*) or (early adj3 prevent*)).m_titl.

#25               22 or 23 or 24

#26               15 and 21 and 25

#27               randomized controlled trial/

#28               randomization/  

#29               controlled study/ 

#30               multicenter study/

#31               phase 3 clinical trial/  

#32               phase 4 clinical trial/

#33               "human*".ti,ab.

#34               (animal* or nonhuman*).ti,ab.

#35               27 or 28 or 29 or 30 or 31 or 32

#36               33 and 34

#37               34 not 33  

#38               35 not 37

#39               26 and 38

#40               (canin* or dog* or rodent* or rat* or mouse or mice* or animal* or mammal* or mice* or bird* or fish* or trout*).m_titl.

#41               39 not 40

Appendix 4. EMBASE (flexible sigmoidoscopy) search strategy

#1        exp colorectal cancer/

#2        exp colorectal tumor/

#3        exp colorectal carcinoma/

#4        exp colorectal adenoma/

#5        exp colon cancer/

#6        exp colon carcinoma/

#7        exp colon cancer/

#8        exp colon adenoma/

#9        exp colon adenocarcinoma/

#10      exp colon tumor/

#11      exp rectum cancer/

#12      exp rectum tumor/  

#13      exp rectum carcinoma/

#14      exp rectum adenoma/

#15                ((colorectal* or CRC or colon or colonic or bowel* or intestine or large intestine or rectal or rectum or sigmoid or anal or anus) and (cancer or neoplasm* or malign* or tumor* or tumour* or carcinom* or sarcom* or adenocarcinom* or adeno?carcinom* or adenom* or lesion*)).m_titl.

#16      1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15

#17      exp gastrointestinal endoscopy/  

#18      exp colonoscopy/

#19      exp sigmoidoscopy/

#20      exp rectoscopy/

#21                (endoscop* or proctoscop* or colonoscop* or sigmoidoscop* or rectosigmoidoscop* or proctosigmoidoscop* or COL or SIG or FSIG or (flex* adj3 sig*)).mp. 

#22      17 or 18 or 19 or 20 or 21

#23      exp mass screening/

#24      exp health survey/

#25                (screen* or test* or (population* adj2 surveillance) or (early adj3 detect*) or (early adj3 prevent*)).m_titl.  

#26      23 or 24 or 25

#27      16 and 22 and 26

#28      randomized controlled trial/

#29      randomization/

#30      controlled study/

#31      multicenter study/

#32      phase 3 clinical trial/

#33      phase 4 clinical trial/

#34      "human*".ti,ab.

#35      (animal* or nonhuman*).ti,ab.

#36      28 or 29 or 30 or 31 or 32 or 33

#37      34 and 35

#38      35 not 37

#39      36 not 38

#40      27 and 39

#41                (canin* or dog* or rodent* or rat* or mouse or mice* or animal* or mammal* or mice* or #bird* or fish* or trout*).m_titl.

#42      40 not 41

Appendix 5. The Cochrane Library (faecal occult blood) search strategy

#1        MeSH descriptor Colorectal Neoplasms explode all trees

#2        MeSH descriptor Colonic Neoplasms explode all trees

#3        MeSH descriptor Rectal Neoplasms explode all trees

#4                  (colorectal* or CRC or colon* or bowel* or intestine* or large intestine* or rectal or rectum or sigmoid or anal or anus) and (cancer or neoplasm* or malign* or tumor or tumour* or carcinom* or sarcom* or adenocarcinom* or adeno?carcinom* or adenom* or lesion*

#5        (#1 OR #2 OR #3 OR #4)

#6        MeSH descriptor Occult Blood explode all trees

#7        MeSH descriptor Immunochemistry explode all trees

#8                  (faecal or fecal or feces or faeces or gFOBT or FOBT or FOB or FIT or haemoccult or hemoccult or sensa) or (heamoccultsensa or hemocare or hema screen or hemascreen or hemacheck or hema check or hemawipe or hema wipe) or (hemofec or hemofecia or fecatest or fecatwin or coloscreen or seracult or ez?detect or colocare or flexsure) or (hemmoquant or immocare or hemochaser or bayer detect or hemeselect or immudia or monohaem or insure or hemodia or instant?view or magstream or guaiac or occult blood) or (stool near3 occult) or (gaiac* near2 smear*)

#9                  (immunochemical* near3 (test* or screen* or diagn*)) or (immunologic* near3 (test* or screen* or diagn*)) or (enzyme or EIA or assay or RPHA or latex or agglutin* or monocl* or polyclo*)

#10      (#6 OR #7 OR #8 OR #9)

#11      MeSH descriptor Mass Screening explode all trees

#12      MeSH descriptor Population Surveillance explode all trees

#13                (screen* or test*) or (population* near2 surveillance) or (early near3 detect*) or (early near3 prevent*)

#14      (#11 OR #12 OR #13)

#15      (#5 AND #10 AND #14)

Appendix 6. The Cochrane Library (flexible sigmoidoscopy) search strategy

#1        MeSH descriptor Colorectal Neoplasms explode all trees

#2        MeSH descriptor Colonic Neoplasms explode all trees

#3        MeSH descriptor Rectal Neoplasms explode all trees

#4                  (colorectal* or CRC or colon* or bowel* or intestine* or large intestine* or rectal or rectum or sigmoid or anal or anus) and (cancer or neoplasm* or malign* or tumor* or tumour* or carcinom* or sarcom* or adenocarcinom* or adeno?carcinom* or adenom* or lesion*

#5        (#1 OR #2 OR #3 OR #4)

#6        MeSH descriptor Endoscopy explode all trees

#7        MeSH descriptor Colonoscopy explode all trees

#8        MeSH descriptor Sigmoidoscopy explode all trees

#9        MeSH descriptor Proctoscopy explode all trees

#10                (endoscop* or proctoscop* or colonoscop* or sigmoidoscop* or rectosigmoidoscop* or proctosigmoidoscop* or COL or SIG or FSIG) or (flex* near3 sig*)

#11      (#6 OR #7 OR #8 OR #9 OR #10)

#12      MeSH descriptor Mass Screening explode all trees

#13      MeSH descriptor Population Surveillance explode all trees

#14                (screen* or test*) or (population* near2 surveillance) or (early near3 detect*) or (early near3 prevent*)

#15      (#12 OR #13 OR #14)

#16      (#5 AND #11 AND #15)

original image
Figuras y tablas -
Figure 1
Ir a la figura de la revisiónAbrir en una pestaña nueva

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Screening procedures versus control ‐ all studies, Outcome 1 Colorectal cancer mortality.
Figuras y tablas -
Analysis 1.1

Comparison 1 Screening procedures versus control ‐ all studies, Outcome 1 Colorectal cancer mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Screening procedures versus control ‐ all studies, Outcome 2 Colorectal cancer incidence.
Figuras y tablas -
Analysis 1.2

Comparison 1 Screening procedures versus control ‐ all studies, Outcome 2 Colorectal cancer incidence.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Screening procedures versus control ‐ all studies, Outcome 3 All‐cause Mortality.
Figuras y tablas -
Analysis 1.3

Comparison 1 Screening procedures versus control ‐ all studies, Outcome 3 All‐cause Mortality.

Ir a la figura de la revisiónAbrir en una pestaña nueva
Summary of findings for the main comparison. Screening for colorectal cancer with flexible sigmoidoscopy or faecal occult blood test

Flexible sigmoidoscopy or faecal occult blood testing compared with care as usual for colorectal cancer screening

Patient or population: Asymptomatic individuals

Settings: Participants recruited among volunteers or randomly chosen from public registries

Intervention: Flexible sigmoidoscopy once only or repeated faecal occult blood testing

Comparison: Care as usual

Outcomes

Illustrative comparative risks1 (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

No screening

Screening group

CRC Mortality ‐ Flexible sigmoidoscopy

8 per 1000

6 per 1000
(5 to 6)

RR 0,72 (0.65 to 0.79)

414,744
(5 studies)

⊕⊕⊕⊕
high

CRC Mortality ‐ Faecal occult blood testing

8 per 1000

7 per 1000
(6 to 7)

RR 0,86 (0.80 to 0.92)

329,642
(4 studies)

⊕⊕⊕⊕
high

CRC incidence ‐ Flexible sigmoidoscopy

20 per 1000

16 per 1000
(15 to 18)

RR 0,82 (0.73 to 0.90)

414,744
(5 studies)

⊕⊕⊕⊝
moderate2

CRC incidence ‐ Faecal occult blood testing

20 per 1000

19 per 1000
(18 to 20 )

RR 0,95 (0,88 to 1,02)

329,536
(4 studies)

⊕⊕⊕⊕
high

All‐cause Mortality ‐ Flexible sigmoidoscopy

254 per 1000

249 per 1000
(241 to 257 )

RR 0,98 (0.95 to 1.01)

364,827
(4 studies)

⊕⊕⊕⊕
high

All‐cause Mortality ‐ Faecal occult blood testing

254 per 1000

254 per 1000
(251 to 257)

RR 1,00 (0,99 to 1,01)

329,642
(4 studies)

⊕⊕⊕⊕
high

CI: Confidence interval; RR: Risk Ratio; CRC: Colorectal cancer

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1Assumed risk is computed by combining events and participants in the control groups in all trials. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

2 Evidence downgraded one level due to heterogeneity between trials. This heterogeneity may be explained by shorter follow‐up of the Norwegian NORCCAP trial, but other explanations like study design cannot be ruled out.

Figuras y tablas -
Summary of findings for the main comparison. Screening for colorectal cancer with flexible sigmoidoscopy or faecal occult blood test
Ir a la tabla de la revisión
Table 1. Characteristics of included studies

Country

Design

Screening

modality

Study period

Age

Control group (n)

Screening group (n)

Men/Women (n)

Compliance+  (%)

Follow‐up

(years)

United States

Volunteers

 

 

gFOBT

1975‐1992*

50‐80

15394

A:15570

B:15587

22367/24184

A: 90

B: 90

18

England

Population based

 

gFOBT

1981‐1995

45‐74

76384

76466

72172/78079++

59

Median 11.7

Denmark

Population based

 

gFOBT

1985‐2002

45‐75

30966

30967

29714/32219

67

17

Sweden

Population based

 

gFOBT

1982‐1995

60‐64

34164

34144

NR

70

Median 15.5

United Kingdom

Volunteers

 

 

FS

1994‐1999

55‐64

112939

57099

83331/86707

71

Median 11.2

United States

Volunteers

FS

1993‐2001

55‐74

77455

77445

76684/78216

Single: 87

Dual: 51

Mortality:

median 12.1

Incidence:

median 11.9

Italy

Volunteers

 

 

FS

1995‐1999

55‐64

17136

17136

17234/17168

58

Mortality:

median 11.4

Incidence:

median 10.5

Norway (NORCCAP)

Population based

 

 

FS

1999‐2000

55‐64

41092

13653

50%**

65

Mortality:  

Median 6

Incidence:

median 7

Norway

(TPS)

Population based

 

FS

1983

50‐59

399

400

400/399

81

13

Characteristics of included studies. *Hiatus in screening 1982‐1986, ** Actual figures not reported, A: Annual screening, B: Biennial screening, NR: Not reported, gFOBT: guaiac faecal occult blood test. FS: Flexible Sigmoidoscopy +At least 1 round in FOBT trials, ++Sum of men and women  does not equal sum of screening and control group due to difference in reporting, please see characteristics of included studies for further explanation.

Figuras y tablas -
Table 1. Characteristics of included studies
Ir a la tabla de la revisión
Table 2. Histologic classification of colorectal cancers in the screening and control groups

 

Screening group

Duke classification

Control group

Duke classification

Country

A

B

C

D

A

B

C

D

FOBT trials

United States

(annual screening)

107/354 (30%)

101/354 (29%)

80/354 

(23%)

33/354

(9%)

88/394

(22%)

120/394 (30%)

82/394

(21 %)

65/394

(17%)

United States

(biennial screening)

98/368

(27%)

95/368

(26%)

100/368 (27%)

41/368

(11%)

88/394

(22%)

120/394 (30%)

82/394

(21%)

65/394

(17%)

England

181/893 (20%)

286/893 (32%)

215/893 (24%)

192/893 (22%)

95/856

(11%)

285/856 (33%)

264/856 (31%)

179/856 (21%)

Denmark

105/481 (22%)

164/481 (34%)

90/481

(19%)

98/481

(20%)

54/483

(11%)

177/483 (37%)

111/483 (23%)

114/483 (24%)

Sweden

124/721 (17%)

261/721 (36%)

184/721 (26%)

152/721 (21%)

112/754 (15%)

260/721 (35%)

221/754 (29%)

161/754 (21%)

Flexible sigmoidoscopy trials

United Kingdom           

NR 

United States

574/955

(60%)

381/955

(40%)

716/1253

(57%)

537/1253

(43%)

Italy*

139/251

(55%)

112/251

(45%)

154/306

(50%)

152/306

(50%)

Norway+ (NORCCAP)

33/123

(27%)

78/123

(63%)

62/362

(17%)

262/362

(72%)

Norway (TPS)

1/2

(50%)

0/2

1/2

(50%)

0/2

0/10

5/10

(50%)

3/10

(30%)

2/10

(20%)

Stages of colorectal cancers diagnosed in the screening and control groups. *Cancers classified according to the Union for International Cancer Control as non‐advanced (Stage I and II) or advanced (Stage III and IV). Non‐advanced cancers equals Duke A and B. Advanced cancers equals Duke C and D. +The Norwegian NORCCAP trial classified cancers according to a modified Duke classification system. Duke A and B cancers were classified as “localized”, but Duke B cancers infiltrating neighbouring organs without distant metastasis were classified as “advanced”. NR: Not reported.

Figuras y tablas -
Table 2. Histologic classification of colorectal cancers in the screening and control groups
Ir a la tabla de la revisión
Table 3. Physical complications to screening

Study

Flexible sigmoidoscopy

Colonoscopy

Bleeding1

Perforation

Death<30days of procedure2

Death <30 days

of surgery

Major complications3

Miscellaneous

United States (gFOBT)

12246

11

4

NR

 NR

 NR

 NR

United States

(FS)

107236

NR

3

NR

NR

NR

NR

17672

NR

19

NR

NR

NR

NR

England (gFOBT)

1474

1

5

0

5 4

 0

15

Sweden (gFOBT)

2108

0

3

0

0

 0

 1415

 

190

1

2

0

0

 0

Norway (FS, NORCCAP)6

12960

0

0

NR

0

 0

387

2524

4

6

NR

0

 0

417

United Kingdom (FS)

403328

129

1

6 10

4 11

312

 

1313

1727

2377

9

4

1 14

 77

Italy (FS)

9911

0

1

NR

NR

NR

607

775

1

1

NR

NR

NR

307

Norway (FS, TPS)

324

0

0

0

0

0

 NR

302

0

0

0

0

0

 NR

TOTAL

172871

12

5

6

4

3

 

 376

 

37560

27

22

1

5

1 Those admitted to hospital due to bleeding

2 Death within 30 days of endoscopic screening or work‐up

3 Bleeding, perforation and death excluded

4 Myocardial infarction, 1 anastomotic leak, 2 pulmonary embolus, 1 carcinomatosis

5 Snare entrapment

6 Includes individuals aged 50‐64 years

7 Minor events not requiring hospitalisation

8 342 individuals had a baseline colonoscopy screening procedure due to strong family history of CRC and is included in the colonoscopy figures

9  Includes 3 individuals with glutaraldehyde colitis

10 3 myocardial infarction, 1 cardiomyopathy, 1 intracerebral haemorrhage, 1 lung cancer

11 2 cardiovascular, 1 respiratory, 1 septicaemia

12 2 myocardial infarction, 1 pulmonary embolus

13 5 cases of definite glutaraldehyde colitis and 8 probable cases

14 Myocardial infarction

15 14 patients who had a laparotomy had complications which prolonged their hospital stay

FS: Flexible sigmoidoscopy. gFOBT: Faecal occult blood test. NORCCAP: Norwegian colorectal cancer prevention trial. TPS: Telemark polyp study

Figuras y tablas -
Table 3. Physical complications to screening
Ir a la tabla de la revisión
Table 4. Mortality rates in screening and control groups

 

                       Screening group

                        Control group      

Risk ratio (95% CI)

 

Study

Screening modality

Personyear

Deaths (n)

Deaths/100000py

Personyear

Deaths (n)    

Deaths/100000py

US (annual)

gFOBT

240325

121

50

237420

177

75

0.68 (0.54‐0.96)

US

(biennial)

gFOBT

240163

148

61

237420

177

75

0.83 (0.66‐1.03)

England

gFOBT

1296712

1176

91

1296614

1300

100

0.91 (0.84‐0.98)

Denmark

gFOBT

431190

362

84

430755

431

100

0.84 (0.73‐0.96)

Sweden

gFOBT

471072

252

53

471980

300

64

0.84 (0.71‐0.99)

UK          

FS

620045

189

30

1224523

538

44

0.69 (0.59‐0.82)

US

FS

868966*

252

29

874358*

341

39

0.74 (0.63‐0.88)

Italy

FS

186745

65

35

187532

83

44

0.78 (0.57‐1.08)

Norway

(NORCCAP)

FS

NR

24

NR

NR

99

NR

0.73 (0.47‐1.14)

Norway (TPS)

FS

NR

1

NR

NR

3

NR

0.33 (0.03‐3.18)

Mortality rates in screening and control groups, NR: Not reported; gFOBT: guaiac faecal occult blood test; FS: Flexible sigmoidoscopy; py: person year; US: United States; UK: United Kingdom. *Estimated numbers.

Figuras y tablas -
Table 4. Mortality rates in screening and control groups
Ir a la tabla de la revisión
Table 5. Incidence rates in screening and control groups

 

                       Screening group

                        Control group

Risk ratio (95% CI)

Study

Screening modality

Personyear

  Cases (n)

Cases/100000py

Personyear

Cases (n)    

Cases/100000py

US (annual)

gFOBT

235584

417

177

232612

507

218

0.81 (0.72‐0.92)

US

(biennial)

gFOBT

235513

435

184

232612

507

218

0.85 (0.75‐0.96)

England

gFOBT

1286526

 2279

177

1286877

2354

183

0.97 (0.91‐1.03)

Denmark

gFOBT

431190

889

206

430755

874

203

1.02 (0.93‐1.12)

Sweden

gFOBT

471072

721

153

471980

754

160

1.10 (0.99‐1.22)

UK          

FS

620045

706

114

1224523

1818

148

0.77 (0.70‐0.84)

US

FS

850420*

1012

119

846710*

1287

152

0.78 (0.72‐0.85)

Italy

FS

174177

251

144

173437

306

176

0.82 (0.70‐0.97)

Norway (NORCCAP)

FS

91449*

123

135

274242*

362

132

1.02 (0.83‐1.25)

Norway (TPS)

FS

NR

2

NR

NR

 10

NR

0.20 (0.04‐0.90)**

Incidence rates in screening and control groups. *Estimated numbers; **From publication; gFOBT: guaiac faecal occult blood test; FS: Flexible sigmoidoscopy; py:person year; CI: Confidence interval; US: United States; UK: United Kingdom; NR: Not reported.

Figuras y tablas -
Table 5. Incidence rates in screening and control groups
Ir a la tabla de la revisión
Comparison 1. Screening procedures versus control ‐ all studies

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Colorectal cancer mortality Show forest plot

9

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Flexible sigmoidoscopy

5

414754

Risk Ratio (M‐H, Fixed, 95% CI)

0.72 [0.65, 0.79]

1.2 Faecal occult blood testing ‐ all studies

4

329642

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.82, 0.92]

1.3 Faecal occult blood testing ‐ biennial screening only

4

305583

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.81, 0.93]

2 Colorectal cancer incidence Show forest plot

9

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Flexible sigmoidoscopy

5

414754

Risk Ratio (M‐H, Random, 95% CI)

0.82 [0.74, 0.90]

2.2 Faecal occult blood testing ‐ all studies

4

329516

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.88, 1.02]

2.3 Faecal occult blood testing ‐ biennial testing only

4

305515

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.90, 1.07]

3 All‐cause Mortality Show forest plot

8

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 Flexible sigmoidoscopy

4

359999

Risk Ratio (M‐H, Random, 95% CI)

0.98 [0.95, 1.01]

3.2 Faecal occult blood testing ‐ all studies

4

329642

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.99, 1.01]
Figuras y tablas -
Comparison 1. Screening procedures versus control ‐ all studies
Ir a la tabla de la revisión