Biennial screening produces sustained mortality reduction in CRC
Click Here to Manage Email Alerts
There was a sustained reduction in mortality among individuals who complied with biennial fecal occult blood test screening for colorectal cancer, according to research published in Clinical Gastroenterology and Hepatology.
Aasma Shaukat, MD, MPH, of the division of gastroenterology at Minneapolis Veterans Affairs Health Care system, and colleagues wrote that previous research has shown that fecal occult blood test (FOBT) screening can reduce CRC-related mortality by up to 21%.
“However, none of the trials were sufficiently powered to study all-cause mortality, the effect of compliance adjustment or whether the screening effects vary by age and sex,” they wrote. “Our aims were to assess the long-term effects of biennial screening on all-cause and CRC mortality using intention to treat and compliance adjustment, and evaluate age- and sex-specific effects by pooling individual participant data from the available randomized controlled trials of biennial FOBT screening, updated through 30 years of follow-up.”
Researchers used updated data from the Danish CRC screening trial (n = 61,933) that included CRC and all-cause mortality, and pooled individual participant data with individual 30-year follow-up data from the Minnesota Colon Cancer Control Trial (n = 46,551). They compared the biennial screening groups to usual care (controls) among individuals aged between 50 and 80 years after adjusting for difference in age, sex and compliance.
Through 30 years of follow-up, investigators identified 33,478 total deaths and 1,023 CRC deaths in the biennial screening group (n = 46,553; 71.9% and 2.2%, respectively), compared with 33,479 total deaths and 1,146 CRC deaths in the control group (n = 46,358; 72.2% and 2.5%, respectively).
Among individuals who complied, biennial FOBT screening reduced CRC mortality by 16% (RR = 0.84; 95% CI, 0.74-0.96) and all cause mortality by 2% (RR = 0.98; 95% CI, 0.97-0.99). In that same group, men had a greater reduction in CRC mortality (RR = 0.75; 95% CI, 0.62-0.9) than women (RR = 0.91; 95% CI, 0.75-1.09).
Researchers found that the largest reduction in CRC mortality was reported in compliant men aged between 60 and 69 years (RR = 0.59; 95% CI, 0.42-0.81) and in women aged 70 years and older (RR = 0.52; 95% CI, 0.3-0.94).
“Our study shows that screening using biennial FOBT results in sustained reductions in CRC mortality and a statistically significant reduction in compliance-adjusted all-cause mortality,” Shaukat and colleagues wrote. “The reduction in CRC mortality is greater in men compared to women, and the benefit in women lags that for men by about 10 years. We did not observe a benefit due to screening in women age 50-59.”
Collapse
Read more about
Click Here to Manage Email Alerts