Document Type
Conference Proceeding
Publication Date
5-3-2024
Abstract
Introduction Colorectal cancer (CRC) is a major public health concern worldwide, with high incidence and mortality rates. Globally, CRC is the third most commonly diagnosed cancer in males and the second in females, according to the World Health Organization GLOBOCAN database. The primary goal of CRC screening is to prevent mortality and morbidity from the disease. USPSTF screening recommendations for colorectal cancer, May 18, 2021: Screen all adults 45 to 75 years of age. Recommended screening strategies include: High-sensitivity guaiac fecal occult blood test (HSgFOBT) or fecal immunochemical test (FIT) every year or Stool DNA-FIT every 1 to 3 years Or Computed tomography colonography every 5 years or Flexible sigmoidoscopy every 5 years or Flexible sigmoidoscopy every 10 years + annual FIT or Colonoscopy screening every 10 years. Additionally, selectively screen adults aged 76 to 85 years for colorectal cancer, considering the patient’s overall health, prior screening history, and patient’s preferences. Methods The search was conducted in PubMed, Medline, and Cochrane Library databases using keywords related to colon cancer screening, mortality, and colon cancer. After initial screening and excluding duplicates, 11 articles were reviewed. Further review with inclusion criteria and excluding 4 ongoing RCTs resulted in 5 studies being included. Result: A systematic review found that early screening and timely diagnosis and treatment effectively reduce disease burden. NordICC trial (M. Bretthauer, M. Løberg E.tal) showed a significant reduction in the risk of colorectal cancer (CRC) with colonoscopy screening but there was no statistical difference in the risk of death from CRC. Likewise, the PLCO trial (Eric A Miller, Paul F Pinsky E. tal) showed a long-term reduction in colorectal cancer incidence and mortality with flexible sigmoidoscopy. Similarly, the Minnesota Colon Cancer Control Study(Aasma Shaukat, Timothy R. Church Et al) observed reduced CRC mortality with annual or biennial screening with fecal occult blood testing. Moreover, the ongoing, Colonoscopy versus FIT in Colorectal-Cancer Screening (Enrique Quintero E. tal) showed the number of colorectal cancer detected was similar in the two study groups, but more adenomas were detected in the colonoscopy group. The comparative effectiveness of FIT and colonoscopy for preventing death from colorectal cancer will be assessed after this 10-year trial. Conclusions: Based on this Systematic review, I would suggest recommending colon cancer screening regardless of methods. It has shown a decrease in the incidence of CRC and has mortality benefits too. But it has some limitations too like a homogenous study population, randomization preceded by informed consent, ongoing trial, and a retrospective study.
Recommended Citation
Gami S, Shah R, Hettiarachchi M. Has colon cancer screening guidelines reduced mortality associated with colon cancer? Presented at: American College of Physicians Michigan Chapter and Society of Hospital Medicine Michigan Chapter 2024 Resident and Medical Student Day; 2024 May 3; Troy, MI
Comments
American College of Physicians Michigan Chapter and Society of Hospital Medicine Michigan Chapter 2024 Resident and Medical Student Day, May 3, 2024, Troy, MI