Review
. 2002 Jul 16;137(2):132-41. doi: 10.7326/0003-4819-137-2-200207160-00015. Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task ForceAffiliations
AffiliationItem in Clipboard
Review
Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task ForceMichael Pignone et al. Ann Intern Med. 2002.
Free article . 2002 Jul 16;137(2):132-41. doi: 10.7326/0003-4819-137-2-200207160-00015. AffiliationItem in Clipboard
AbstractPurpose: To assess the effectiveness of different colorectal cancer screening tests for adults at average risk.
Data sources: Recent systematic reviews; Guide to Clinical Preventive Services, 2nd edition; and focused searches of MEDLINE from 1966 through September 2001. The authors also conducted hand searches, reviewed bibliographies, and consulted context experts to ensure completeness.
Study selection: When available, the most recent high-quality systematic review was used to identify relevant articles. This review was then supplemented with a MEDLINE search for more recent articles.
Data extraction: One reviewer abstracted information from the final set of studies into evidence tables, and a second reviewer checked the tables for accuracy. Discrepancies were resolved by consensus.
Data synthesis: For average-risk adults older than 50 years of age, evidence from multiple well-conducted randomized trials supported the effectiveness of fecal occult blood testing in reducing colorectal cancer incidence and mortality rates compared with no screening. Data from well-conducted case-control studies supported the effectiveness of sigmoidoscopy and possibly colonoscopy in reducing colon cancer incidence and mortality rates. A nonrandomized, controlled trial examining colorectal cancer mortality rates and randomized trials examining diagnostic yield supported the use of fecal occult blood testing plus sigmoidoscopy. The effectiveness of barium enema is unclear. Data are insufficient to support a definitive determination of the most effective screening strategy.
Conclusions: Colorectal cancer screening reduces death from colorectal cancer and can decrease the incidence of disease through removal of adenomatous polyps. Several available screening options seem to be effective, but the single best screening approach cannot be determined because data are insufficient.
Comment inKirkpatrick DM. Kirkpatrick DM. Ann Intern Med. 2003 Feb 18;138(4):356; author reply 357. doi: 10.7326/0003-4819-138-4-200302180-00020. Ann Intern Med. 2003. PMID: 12585839 No abstract available.
Rosson RS, Spiro HM. Rosson RS, et al. Ann Intern Med. 2003 Feb 18;138(4):356-7; author reply 357. doi: 10.7326/0003-4819-138-4-200302180-00022. Ann Intern Med. 2003. PMID: 12585841 No abstract available.
[No authors listed] [No authors listed] Ann Intern Med. 2002 Jul 16;137(2):I38. doi: 10.7326/0003-4819-137-2-200207160-00003. Ann Intern Med. 2002. PMID: 12118986 No abstract available.
Walsh JM, Terdiman JP. Walsh JM, et al. JAMA. 2003 Mar 12;289(10):1288-96. doi: 10.1001/jama.289.10.1288. JAMA. 2003. PMID: 12633191 Review.
Pignone M, Saha S, Hoerger T, Mandelblatt J. Pignone M, et al. Ann Intern Med. 2002 Jul 16;137(2):96-104. doi: 10.7326/0003-4819-137-2-200207160-00007. Ann Intern Med. 2002. PMID: 12118964 Review.
U.S. Preventive Services Task Force. U.S. Preventive Services Task Force. Ann Intern Med. 2002 Jul 16;137(2):129-31. doi: 10.7326/0003-4819-137-2-200207160-00014. Ann Intern Med. 2002. PMID: 12118971
Sonnenberg A, Delcò F, Inadomi JM. Sonnenberg A, et al. Ann Intern Med. 2000 Oct 17;133(8):573-84. doi: 10.7326/0003-4819-133-8-200010170-00007. Ann Intern Med. 2000. PMID: 11033584
McLeod RS; Canadian Task Force on Preventive Health Care. McLeod RS, et al. Can J Gastroenterol. 2001 Oct;15(10):647-60. doi: 10.1155/2001/284746. Can J Gastroenterol. 2001. PMID: 11694901 Review.
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