The Impact of Screening on Colorectal Cancer Mortality and Incidence: Has It Really Made a Difference?

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• 作者：Ann G. Zauber (1)
  
  1. Department of Epidemiology and Biostatistics ; Memorial Sloan Kettering Cancer Center ; New York ; NY ; 10065 ; USA
  
• 关键词：Colorectal cancer screening ; Impact of screening ; Incidence and mortality
• 刊名：Digestive Diseases and Sciences
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：60
• 期：3
• 页码：681-691
• 全文大小：1,634 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Gastroenterology
  Hepatology
  Oncology
  Transplant Surgery
  Biochemistry
  
• 出版者：Springer Netherlands
• ISSN：1573-2568

文摘

About sixty percent of the US population of those age fifty and older are currently up to date with colorectal cancer screening recommendations. Has this level of screening made a difference for reducing colorectal cancer (CRC) incidence and/or mortality? Randomized controlled trials of guaiac-based fecal occult blood tests, which have relatively low sensitivity but high specificity for CRC, have shown a modest effect but with a long-term reduction in CRC mortality. Newer fecal immunochemical tests are expected to have a greater effect. Randomized controlled trials of flexible sigmoidoscopy have also demonstrated a reduction in CRC mortality. Observational studies of screening colonoscopy suggest an effect of greater than fifty percent reduction in CRC mortality. We have assessed past trends of colorectal cancer screening in the US population which suggest that more than fifty percent of the decline in colorectal cancer mortality can be attributed to the increased acceptance and uptake in colorectal cancer screening. Current and future levels of increased screening could provide for even larger reductions for the USA. Colorectal cancer screening has and will continue to make a significant impact on reducing colorectal cancer mortality.