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Potential biases in colorectal cancer screening using faecal occult blood test

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Authors:
  • Riboe, Dea Grip ;
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    Forskningsenheden for Almen Praksis, Eksterne centre, Københavns Universitet
  • Dogan, Tilde Steen ;
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    Forskningsenheden for Almen Praksis, Eksterne centre, Københavns Universitet
  • Brodersen, John
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    Forskningsenheden for Almen Praksis, Eksterne centre, Københavns Universitet
DOI:
10.1111/j.1365-2753.2012.01824.x.
Abstract:
BACKGROUND: Colorectal cancer (CRC) is one of the most common types of cancer in European countries and associated with a high mortality rate. A 16% relative risk reduction (RRR) of mortality was found in a meta-analysis based on four randomized controlled trials (RCT) on CRC screening. The aim of this paper was to scrutinize these trials for potential biases and assess their influence on the screening trials. METHODS: The four RCTs were reviewed based on the principles of 'Critical Appraisal of the Medical Literature'. Principal investigators of the four RCTs were contacted to clarify uncertainties in their study. Data were collected from The Danish Data Archives. Authors of the Cochrane review were contacted. RESULTS: Six biases were identified, of which five favour screening. Three of the biases identified were specific to CRC screening: type of diagnostic method, place of surgery and diagnostic delay. CONCLUSION: The 16% RRR in CRC mortality found in the updated Cochrane review's meta-analysis is overestimated.
Type:
Journal article
Language:
English
Published in:
Journal of Evaluation in Clinical Practice, 2013, Vol 19, Issue 2, p. 311-316
Keywords:
Bias (Epidemiology); Colorectal Neoplasms; Databases, Factual; Denmark; Early Detection of Cancer; Humans; Mass Spectrometry; Occult Blood; Randomized Controlled Trials as Topic; Research Design; Journal Article; Meta-Analysis
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2013
Scientific Level:
Scientific
ID:
239042407

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