RetroSearch Browse

Home - News ( United States | United Kingdom | Italy | Germany ) - Football scores

Showing content from https://pubmed.ncbi.nlm.nih.gov/29710125/ below:

Long-Term Effectiveness of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality in Women and Men: A Randomized Trial

Randomized Controlled Trial

. 2018 Jun 5;168(11):775-782. doi: 10.7326/M17-1441. Epub 2018 Apr 24. Long-Term Effectiveness of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality in Women and Men: A Randomized Trial Magnus Løberg¹, Mette Kalager², Michael Bretthauer¹, Miguel A Hernán², Eline Aas³, Tor J Eide¹, Eva Skovlund⁴, Jon Lekven⁵, Jörn Schneede⁶, Kjell Magne Tveit⁷, Morten Vatn⁷, Giske Ursin⁸, Geir Hoff⁹; NORCCAP Study Group†

Collaborators, Affiliations

Collaborators

NORCCAP Study Group†: Per Efskind, Ghous Gondal, Gert Huppertz-Hauss, Miguel A Hernán, Bjørn Hofstad, Øyvind Holme, Solveig Thorp Holmsen, Mette Kalager, Inger Kristin Larsen, Magnus Løberg, Volker Moritz, Sverre Nyhus, Espen Thiis-Evensen, Tom Grotmol, Eline Aas, Giske Ursin, Geir Hoff, Eva Skovlund, Morten Vatn, Tor Iversen, Jörn Schneede, Michael Bretthauer, Kjell Magne Tveit, Jon Lekven, Tor J Eide

Affiliations

¹ Sørlandet Hospital Kristiansand, Kristiansand, Norway, and University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway (Ø.H., M.L., M.B., T.J.E.).
² University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway, and Harvard T.H. Chan School of Public Health and Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts (M.K., M.A.H.).
³ Harvard T.H. Chan School of Public Health and Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts; University of Oslo Institute of Health and Society, Oslo, Norway (E.A.).
⁴ Oslo University Hospital, Oslo, Norway; orwegian University of Science and Technology, Trondheim, Norway (E.S.).
⁵ University of Bergen Surgical Research Laboratory, Bergen, Norway (J.L.).
⁶ Umeå University Clinical Pharmacology Unit, Umeå, Sweden (J.S.).
⁷ Oslo University Hospital and University of Oslo Institute of Clinical Medicine, Oslo, Norway (K.M.T., M.V.).
⁸ University of Oslo Institute of Clinical Medicine, Oslo, Norway; Cancer Registry of Norway and University of Oslo Institute of Basic Medical Sciences, Oslo, Norway, and University of Southern California Keck School of Medicine, Los Angeles, California (G.U.).
⁹ University of Oslo Institute of Clinical Medicine and Cancer Registry of Norway, Oslo, Norway, and Telemark Hospital, Skien, Norway (G.H.).

PMID: 29710125
PMCID: PMC6853067
DOI: 10.7326/M17-1441

Item in Clipboard

Randomized Controlled Trial

Long-Term Effectiveness of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality in Women and Men: A Randomized Trial

Øyvind Holme et al. Ann Intern Med. 2018.

. 2018 Jun 5;168(11):775-782. doi: 10.7326/M17-1441. Epub 2018 Apr 24. Authors Øyvind Holme¹, Magnus Løberg¹, Mette Kalager², Michael Bretthauer¹, Miguel A Hernán², Eline Aas³, Tor J Eide¹, Eva Skovlund⁴, Jon Lekven⁵, Jörn Schneede⁶, Kjell Magne Tveit⁷, Morten Vatn⁷, Giske Ursin⁸, Geir Hoff⁹; NORCCAP Study Group† Collaborators

NORCCAP Study Group†: Per Efskind, Ghous Gondal, Gert Huppertz-Hauss, Miguel A Hernán, Bjørn Hofstad, Øyvind Holme, Solveig Thorp Holmsen, Mette Kalager, Inger Kristin Larsen, Magnus Løberg, Volker Moritz, Sverre Nyhus, Espen Thiis-Evensen, Tom Grotmol, Eline Aas, Giske Ursin, Geir Hoff, Eva Skovlund, Morten Vatn, Tor Iversen, Jörn Schneede, Michael Bretthauer, Kjell Magne Tveit, Jon Lekven, Tor J Eide

Affiliations

¹ Sørlandet Hospital Kristiansand, Kristiansand, Norway, and University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway (Ø.H., M.L., M.B., T.J.E.).
² University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway, and Harvard T.H. Chan School of Public Health and Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts (M.K., M.A.H.).
³ Harvard T.H. Chan School of Public Health and Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts; University of Oslo Institute of Health and Society, Oslo, Norway (E.A.).
⁴ Oslo University Hospital, Oslo, Norway; orwegian University of Science and Technology, Trondheim, Norway (E.S.).
⁵ University of Bergen Surgical Research Laboratory, Bergen, Norway (J.L.).
⁶ Umeå University Clinical Pharmacology Unit, Umeå, Sweden (J.S.).
⁷ Oslo University Hospital and University of Oslo Institute of Clinical Medicine, Oslo, Norway (K.M.T., M.V.).
⁸ University of Oslo Institute of Clinical Medicine, Oslo, Norway; Cancer Registry of Norway and University of Oslo Institute of Basic Medical Sciences, Oslo, Norway, and University of Southern California Keck School of Medicine, Los Angeles, California (G.U.).
⁹ University of Oslo Institute of Clinical Medicine and Cancer Registry of Norway, Oslo, Norway, and Telemark Hospital, Skien, Norway (G.H.).

PMID: 29710125
PMCID: PMC6853067
DOI: 10.7326/M17-1441

Item in Clipboard

Abstract

Background: The long-term effects of sigmoidoscopy screening on colorectal cancer (CRC) incidence and mortality in women and men are unclear.

Objective: To determine the effectiveness of flexible sigmoidoscopy screening after 15 years of follow-up in women and men.

Design: Randomized controlled trial. (ClinicalTrials.gov: NCT00119912).

Setting: Oslo and Telemark County, Norway.

Participants: Adults aged 50 to 64 years at baseline without prior CRC.

Intervention: Screening (between 1999 and 2001) with flexible sigmoidoscopy with and without additional fecal blood testing versus no screening. Participants with positive screening results were offered colonoscopy.

Measurements: Age-adjusted CRC incidence and mortality stratified by sex.

Results: Of 98 678 persons, 20 552 were randomly assigned to screening and 78 126 to no screening. Adherence rates were 64.7% in women and 61.4% in men. Median follow-up was 14.8 years. The absolute risks for CRC in women were 1.86% in the screening group and 2.05% in the control group (risk difference, -0.19 percentage point [95% CI, -0.49 to 0.11 percentage point]; HR, 0.92 [CI, 0.79 to 1.07]). In men, the corresponding risks were 1.72% and 2.50%, respectively (risk difference, -0.78 percentage point [CI, -1.08 to -0.48 percentage points]; hazard ratio [HR], 0.66 [CI, 0.57 to 0.78]) (P for heterogeneity = 0.004). The absolute risks for death from CRC in women were 0.60% in the screening group and 0.59% in the control group (risk difference, 0.01 percentage point [CI, -0.16 to 0.18 percentage point]; HR, 1.01 [CI, 0.77 to 1.33]). The corresponding risks for death from CRC in men were 0.49% and 0.81%, respectively (risk difference, -0.33 percentage point [CI, -0.49 to -0.16 percentage point]; HR, 0.63 [CI, 0.47 to 0.83]) (P for heterogeneity = 0.014).

Limitation: Follow-up through national registries.

Conclusion: Offering sigmoidoscopy screening in Norway reduced CRC incidence and mortality in men but had little or no effect in women.

Primary funding source: Norwegian government and Norwegian Cancer Society.

PubMed Disclaimer

Conflict of interest statement

Disclosures: All authors report no conflicts of interest.

Figures
Appendix Figure 1

Study flow chart. CRC…

Appendix Figure 1

Study flow chart. CRC = colorectal cancer; FOBT = fecal occult blood…

Appendix Figure 1

Study flow chart. CRC = colorectal cancer; FOBT = fecal occult blood testing.

Appendix Figure 2

Risks for CRC, rectosigmoid…

Appendix Figure 2

Risks for CRC, rectosigmoid cancer, and death from CRC for women and…

Appendix Figure 2

Risks for CRC, rectosigmoid cancer, and death from CRC for women and men in the screening and control groups. CRC = colorectal cancer.

Appendix Figure 3

Fifteen-year risks for CRC…

Appendix Figure 3

Fifteen-year risks for CRC and death from CRC with and without screening…

Appendix Figure 3

Fifteen-year risks for CRC and death from CRC with and without screening for women and men. CRC = colorectal cancer.

Figure 1:. Risk of colorectal cancer, rectosigmoid…

Figure 1:. Risk of colorectal cancer, rectosigmoid cancer, and colorectal cancer mortality for men and…
Figure 1:. Risk of colorectal cancer, rectosigmoid cancer, and colorectal cancer mortality for men and women in the screening and control groups.

Panel A: colorectal cancer risk in women; Panel B: colorectal cancer risk in men; Panel C: rectosigmoid cancer risk in women; Panel D: rectosigmoid cancer risk in men; Panel E: colorectal cancer mortality risk in women; Panel F: colorectal cancer mortality risk in men

Figure 2:

15-year risks of colorectal cancer…

Figure 2:

15-year risks of colorectal cancer (light-blue) and colorectal cancer mortality (dark blue) with…

Figure 2:

15-year risks of colorectal cancer (light-blue) and colorectal cancer mortality (dark blue) with and without screening for men and women

Comment in

Why "More Research Is Needed," Despite Overall Certainty: Women and Colorectal Cancer Screening.
Bibbins-Domingo K, Inadomi J. Bibbins-Domingo K, et al. Ann Intern Med. 2018 Jun 5;168(11):824-825. doi: 10.7326/M18-0963. Epub 2018 Apr 24. Ann Intern Med. 2018. PMID: 29710347 No abstract available.
Long-Term Effectiveness of Sigmoidoscopy Screening in Women and Men.
Shaukat A, Church TR. Shaukat A, et al. Ann Intern Med. 2018 Nov 6;169(9):663. doi: 10.7326/L18-0511. Ann Intern Med. 2018. PMID: 30398635 No abstract available.
Long-Term Effectiveness of Sigmoidoscopy Screening in Women and Men.
Holme Ø, Løberg M, Kalager M, Bretthauer M, Hoff G. Holme Ø, et al. Ann Intern Med. 2018 Nov 6;169(9):663-664. doi: 10.7326/L18-0512. Ann Intern Med. 2018. PMID: 30398636 No abstract available.