Colorectal Cancer Screening (PDQ®)–Health Professional Version

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Changes to This Summary (07/28/2017)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Summary of Evidence

Added text to state that in addition, there is solid evidence that some colorectal cancer (CRC) screening modalities also reduce CRC incidence. Also revised text to state that a meta-analysis of flexible sigmoidoscopy randomized controlled trials (RCTs) found that screening with sigmoidoscopy reduces all-cause mortality.

Revised Table 1 to include the magnitude of effect of screening interventions on CRC incidence.

Description of the Evidence

Revised Table 2 to include the relative risk of CRC mortality and the risk ratio of CRC incidence for screening by guaiac-based fecal occult blood testing.

Revised text to state that four major sigmoidoscopy screening RCTs have reported incidence and mortality results, with a very small fifth RCT that had 800 total participants; median follow-up was approximately 11 years for each group. Also added text to state that a meta-analysis showed a significant effect on all-cause mortality (cited Tinmouth et al. as reference 39).

Added text about the United Kingdom trial that published an extended follow-up analysis in 2017, with median follow-up of 17.1 years.

Revised Table 3 to include the CRC incidence reduction for screening by sigmoidoscopy.

Evidence of Harms

Added text about a systematic review of 60 studies that assessed complications of colonoscopy screening in asymptomatic patients and found serious morbidity, which comprised major bleeding and perforation, and only minor and short-lasting psychological harms (cited Vermeer et al. as reference 6).

This summary is written and maintained by the PDQ Screening and Prevention Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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