Effect of flexible sigmoidoscopy-based screening on colorectal cancer incidence and mortality: an updated systematic review and meta-analysis of randomized controlled trials.

IF 2.9 3区医学 Q2 ONCOLOGY Expert Review of Anticancer Therapy Pub Date : 2023-07-01 Epub Date: 2023-08-08 DOI:10.1080/14737140.2023.2245564

Chengren Zhang, Lili Liu, Jingjing Li, Yaochun Lv, Dewang Wu, Shiyun Xu, Cong Cao, Lixia Zhao, Yijun Liu, Xiaolong Ma, Xiongfei Yang, Binbin Du

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Abstract

Objective: Our objective was to estimate the effect of flexible sigmoidoscopy (FS)-based screening on colorectal cancer (CRC) incidence and mortality by conducting an updated meta-analysis of randomized controlled trials (RCTs).

Methods: PubMed, Web of Science, Embase, and Cochrane Library searched for RCTs from database inception to December 2022. The methodological quality of the RCTs was assessed using the Cochrane Collaboration Risk of Bias Tool. RevMan 5.4 was used for this meta-analysis.

Results: Four RCTs involving 457, 871 patients were included. This meta-analysis revealed that FS-based screening was associated with a 20% relative risk reduction in CRC incidence [RR = 0.80; 95% CI (0.75, 0.86); P < 0.00001], and a 24% reduction in CRC mortality [RR = 0.76; 95% CI (0.70, 0.82); P < 0.00001]. In addition, this meta-analysis revealed that FS-based screening reduced the incidence[RR = 0.68; 95% CI (0.60, 0.77); P < 0.00001] and mortality[RR = 0.64; 95% CI (0.49, 0.83); P = 0.0007] of distal CRC, but had no significant effect on proximal colon cancer.

Conclusion: FS-based screening appeared to be effective in reducing distal CRC incidence and mortality in patients at average risk compared to no intervention, but had no significant effect on proximal colon cancer.

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柔性乙状结肠镜筛查对结直肠癌癌症发病率和死亡率的影响：随机对照试验的最新系统回顾和荟萃分析。

目的：我们的目的是通过对随机对照试验（RCT）进行最新的荟萃分析，评估基于乙状结肠镜（FS）的筛查对癌症（CRC）发病率和死亡率的影响。方法：PubMed、Web of Science、Embase和Cochrane Library从数据库建立到2022年12月搜索RCT。使用Cochrane协作偏倚风险工具评估随机对照试验的方法学质量。RevMan 5.4用于此荟萃分析。结果：纳入4项随机对照试验，涉及457871名患者。这项荟萃分析显示，基于FS的筛查与CRC发病率降低20%的相对风险相关[RR = 0.80；95%可信区间（0.75，0.86）；P P 0.00001]。此外，这项荟萃分析显示，基于FS的筛查降低了发病率[RR = 0.68；95%可信区间（0.60，0.77）；P P = 0.0007]，但对近端结肠癌癌症无显著影响。结论：与不干预相比，FS-based筛查在降低平均风险患者的远端CRC发病率和死亡率方面似乎是有效的，但对癌症近端没有显著影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anticancer Therapy 医学-肿瘤学

CiteScore

5.10

自引率

3.00%

发文量

100

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.