TY - JOUR
T1 - A systematic review of the effects of screening for colorectal cancer using the faecal occult blood test, Hemoccult
AU - Towler, Bernie
AU - Irwig, Les
AU - Glasziou, Paul
AU - Kewenter, Jan
AU - Weller, David
AU - Silagy, Chris
PY - 1998/8/29
Y1 - 1998/8/29
N2 - Objective: To review effectiveness of screening for colorectal cancer with faecal occult blood test, Hemoccult, and to consider benefits and harms of screening. Design: Systematic review of trials of Hemoccult screening, with meta-analysis of results from die randomised controlled trials. Subjects: Four randomised controlled trials and two non-randomised trials of about 330,000 and 113,000 people respectively aged ≤ 40 years in five countries. Main outcome measures: Meta-analysis of effects of screening on mortality from colorectal cancer Results: Quality of trial design was generally high, and screening resulted in a favourable shift in the stage distribution of colorectal cancers in the screening groups. Meta-analysis of mortality results from the four randomised controlled trials showed that those allocated to screening had a reduction in mortality from colorectal cancer of 16% (relative risk 0.84 (95% confidence interval 0.77 to 0.93)). When adjusted for attendance for screening, this reduction was 23% (relative risk 0.77 (0.57 to 0.89)) for people actually screened. If a biennial Hemoccult screening programme were offered to 10,000 people and about two thirds attended for at least one Hemoccult test, 8.5 (3.6 to 13.5) deaths from colorectal cancer would be prevented over a period of 10 years. Conclusion: Although benefits of screening are likely to outweigh harms for populations at high risk of colorectal cancer, more information is needed about the harmful effects of screening, the community's responses to screening, and costs of screening for different healthcare systems before widespread screening can be recommended.
AB - Objective: To review effectiveness of screening for colorectal cancer with faecal occult blood test, Hemoccult, and to consider benefits and harms of screening. Design: Systematic review of trials of Hemoccult screening, with meta-analysis of results from die randomised controlled trials. Subjects: Four randomised controlled trials and two non-randomised trials of about 330,000 and 113,000 people respectively aged ≤ 40 years in five countries. Main outcome measures: Meta-analysis of effects of screening on mortality from colorectal cancer Results: Quality of trial design was generally high, and screening resulted in a favourable shift in the stage distribution of colorectal cancers in the screening groups. Meta-analysis of mortality results from the four randomised controlled trials showed that those allocated to screening had a reduction in mortality from colorectal cancer of 16% (relative risk 0.84 (95% confidence interval 0.77 to 0.93)). When adjusted for attendance for screening, this reduction was 23% (relative risk 0.77 (0.57 to 0.89)) for people actually screened. If a biennial Hemoccult screening programme were offered to 10,000 people and about two thirds attended for at least one Hemoccult test, 8.5 (3.6 to 13.5) deaths from colorectal cancer would be prevented over a period of 10 years. Conclusion: Although benefits of screening are likely to outweigh harms for populations at high risk of colorectal cancer, more information is needed about the harmful effects of screening, the community's responses to screening, and costs of screening for different healthcare systems before widespread screening can be recommended.
UR - http://www.scopus.com/inward/record.url?scp=0032578325&partnerID=8YFLogxK
U2 - 10.1136/bmj.317.7158.559
DO - 10.1136/bmj.317.7158.559
M3 - Article
C2 - 9721111
AN - SCOPUS:0032578325
SN - 0959-8146
VL - 317
SP - 559
EP - 565
JO - British Medical Journal
JF - British Medical Journal
IS - 7158
ER -