Report in English with a Dutch summary (KCE reports 45A)

56 Screening for Colorectal Cancer KCE reports vol.45
5 CLINICAL EFFECTIVENESS OF MASS
SCREENING FOR COLORECTAL CANCER
5.1 INTRODUCTION
Citation count
600
500
400
300
200
100
0
Screening and surveillance of colorectal cancer (CRC) appear to be topics of
major interest in medical & public health communities worldwide, with
increasing Medline citation numbers in the past 10 years (Figure 13).
Number of Medline citations on CRC screening or surveillance - last 10 years
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 (8 m)
Publicatons year
Figure 13: Medline citations on CRC screening or surveillance in last
10 years
A quick explorative Medline search, focusing on colorectal cancer combined
with either screening or surveillance and limited to the last two years,
yielded 896, respectively 139 citations if restricted to core clinical journals (see
appendix).
After a first selection on systematic reviews our attention quickly focussed on
an exhaustive systematic review from the New Zealand Health Technology
Assessment group (NZHTA), published in 2005 219 and covering the literature
between January 1997 and October 2004. This review in itself was an update of
a previous systematic review from 1998 220. The NZHTA review considered all
screening options available, but concentrated on fecal occult blood test (FOBT),
guaiac tests as well as on immunochemical FOBT, and flexible sigmoidoscopy
(FS). For the other techniques a lack of available RCTs with appropriate
outcome variables was reported.
In order to include more recent evidence we performed an incremental search
of the scientific literature to cover the period since October 2004. However,
much of the evidence presented in this chapter will be based on this previous
systematic review.
5.2 INCREMENTAL SEARCH ON CLINICAL EFFECTIVENESS
OF COLORECTAL SCREENING
The core searches on CRC screening of the NZHTA rapport were repeated, all
searches being limited to the years 2004 (October to December) to 2006