Sign up now for ease of access to The Medical Independent, Ireland’s most frequently published medical newspaper, delivering award-winning news and investigative reporting.
Established in 2010, along with its sister publication The Medical Independent, our stated aim is to investigate and analyse the major issues affecting healthcare and the medical profession in Ireland. The Medical Independent has won a number of awards for its investigative journalism, and its stories are frequently picked up by national digital, broadcast and print media. The Medical Independent is published by GreenCross Publishing.
Address: Top Floor, 111 Rathmines Road Lr, Dublin 6
Tel: 353 (01) 441 0024
GreenCross Publishing is owned by Graham Cooke.
Colorectal cancer (CRC) screening has been introduced in many countries with the most frequently used methods being repeated endoscopy (usually colonoscopy, but also less invasive sigmoidoscopy) and faecal testing. However, the latest findings of the randomised controlled Italian Flexible Sigmoidoscopy Screening Trial (SCORE), as outlined in a recent article in the Annals of Internal Medicine, coupled with the results from other trials, suggest the need to
revise those recommendations.
The protective effect of a single flexible sigmoidoscopy screening in older adults was maintained for up 15 years against colorectal cancer incidence and for up to 19 years against mortality, according to the long-term follow-up findings of the SCORE trial.
In the SCORE trial, 34,272 adults aged 55-to-64 years were randomly assigned in a 1:1 ratio to receive flexible sigmoidoscopy screening or usual care. A total of 9,911 participants ended up having screening in the intervention group. Median follow-up was 15.4 years for incidence and 18.8 years for mortality. Incidence of CRC was reduced by 19 per cent (RR 0.81 [95% CI, 0.71 to 0.93]) in the intention-to-treat (ITT) analysis, comparing the intervention with the control group, and by 33 per cent (RR 0.67 [CI, 0.56 to 0.81]) in the per protocol (PP) analysis, comparing participants screened in the intervention group with the control persons.
CRC mortality was reduced by 22 per cent (RR 0.78 [CI, 0.61 to 0.98]) in the ITT analysis and by 39 per cent (RR 0.61 [CI, 0.44-0.84]) in the PP analysis. Incidence of CRC was statistically significantly reduced among both men and women. However, CRC mortality was statistically significantly reduced among men (ITT RR 0.73 [CI, 0.54-0.97]), but not among women (ITT RR 0.90 [CI, 0.59-1.37]). “The benefit-to-harm ratio of this strategy would be improved when adopting a
once-in-a-lifetime approach because of the substantial reduction in the burden associated with screening as well as the reduction in healthcare costs,” the researchers wrote.
In a related editorial in the Annals of Internal Medicine, Dr Michael Bretthauer, from the University of Oslo and University of Tromsø in Norway, and colleagues, mentioned that when endoscopic screening was first discussed in the early 1990s, “colonoscopy was regarded as too invasive, too resource demanding, and too burdensome on patients to be seriously considered as a screening test.” The findings from the Italian trial bring an end to a “remarkable, three decades long era in colorectal cancer screening”, they said.
Results of a new study indicate patients with lymphoma are more likely to develop post-vaccination Covid-19...
New international clinical practice guidelines have been published for the diagnosis and management of von Willebrand...
The ICGP is examining alternative pathways for entry into general practice training as part of efforts...
In December, the HSE released part of an external review into the case of 'Brandon', a...
The evidence on doctor burnout “should scare us and concern us”, the Director of the RCSI...
A review of public health governance structures and addressing “longstanding” IT infrastructure...
Leave a Reply
You must be logged in to post a comment.