Authors' objectives:

This review aims to assess the effectiveness and cost-effectiveness of different colorectal cancer screening tests.

Authors' results and conclusions: Direct evidence from multiple well-conducted randomized trials supports the effectiveness of fecal occult blood testing (FOBT) in decreasing colon cancer incidence and reducing mortality from colorectal cancer compared with no screening for average-risk adults over age 50. Data from well-conducted case-control studies support the effectiveness of sigmoidoscopy and possibly colonoscopy in reducing colon cancer mortality as well. A nonrandomized trial and indirect evidence support the use of combination FOBT and sigmoidoscopy. Indirect evidence from diagnostic accuracy studies suggests that double-contrast barium enema or virtual colonoscopy may also be effective compared with no screening. Data are insufficient to determine with confidence and precision the most effective or cost-effective strategies or the age at which screening should be stopped.

Authors' recommendations: Colorectal cancer screening is effective in reducing mortality from colorectal cancer. Current data are insufficient to determine the most effective or cost-effective strategy for screening, although all major strategies have favorable cost-effectiveness ratios compared with no screening.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/uspstf/uspscolo.htm

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)