Screening strategies for colorectal cancer: systematic review and recommendations
McLeod R, with the Canadian Task Force on Preventive Health Care
Record ID 32003000023
English
Authors' objectives:
The aims of this report were to make recommendations on the effectiveness of specific screening techniques for colorectal cancer in asymptomatic patients.
Effectiveness in normal risk patients was reviewed for: 1) multiphase screening with the Hemoccult test as first phase; 2) multiphase screening with sigmoidoscopy; 3) uniphase screening with colonoscopy.
For above average risk patients, the specific screening maneuvers reviewed were: 1) flexible sigmoidoscopy and genetic testing for those with familial adenomatous polyposis (FAP); 2) colonoscopy for hereditary nonpolyposis colon cancer (HNPCC); 3) colonoscopy for patients with family history (1st degree relative(s)) of polyps/colorectal cancer.
Authors' recommendations:
Normal risk individuals: There is good evidence to support the inclusion of annual or biennial fecal occult blood testing and fair evidence to include flexible sigmoidoscopy in the periodic health examinations of asymptomatic individuals over age 50 years. There is insufficient evidence to make recommendations about whether only 1 or both of FOBT and sigmoidoscopy should be performed. There is insufficient evidence to include or exclude colonoscopy as an initial screen in the periodic health examination.
Above average risk individuals: There is fair evidence to support either genetic testing or flexible sigmoidoscopy of at risk individuals in FAP kindreds and screening with colonoscopy of patients in kindreds with the cancer family syndrome (HNPCC). There is insufficient evidence to recommend colonoscopy for individuals who have a family history of colorectal polyps or cancer but do not fit the criteria for HNPCC. Development of better risk stratification for screening is a high research priority and further research, including randomized controlled trials, into the effectiveness and feasibility of other screening modalities is necessary.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.ctfphc.org/
Year Published:
2001
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Mass Screening
- Colorectal Neoplasms
Contact
Organisation Name:
Canadian Task Force on Preventive Health Care
Contact Address:
Canadian Task Force on Preventive Health Care, 100 Collip Circle, Suite 117, London, ON, N6G 4X8, Canada. Tel: 519-858-5181; Fax: 519-858-5112
Contact Name:
ctf@ctfphc.org
Contact Email:
ctf@ctfphc.org
Copyright:
Canadian Task Force on Preventive Health Care (CTFPHC)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.