Antonio Federici, Ministero della Salute, Livia Giordano, CPO Torino; Teresa Spadea, Rete Epidemiologia Piemonte, ASL 3 Torino; Anna Iossa, ISPO Firenze, Carla Cogo, Registro Tumori del Veneto Istituto Oncologico Veneto, Padova; Carlo Senore, CPO Torino, Fabio Palazzo, CNR Roma; Mauro Palazzi, Azienda USL Cesena; Giacomo Furnari, Laziosanità, Agenzia di Sanità Pubblica, Regione Lazio; Alessandra Barca, Laziosanità Agenzia di Sanità Pubblica, Regione Lazio, Roma.
Meta-analysis: adherence to colorectal cancer screening and the detection rate for advanced neoplasia, according to the type of screening test
Article first published online: 4 OCT 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 36, Issue 10, pages 929–940, November 2012
How to Cite
Hassan, C., Rossi, P. G., Camilloni, L., Rex, D. K., Jimenez-Cendales, B., Ferroni, E., Borgia, P., Zullo, A., Guasticchi, G. and Group, H. (2012), Meta-analysis: adherence to colorectal cancer screening and the detection rate for advanced neoplasia, according to the type of screening test. Alimentary Pharmacology & Therapeutics, 36: 929–940. doi: 10.1111/apt.12071
- Issue published online: 16 OCT 2012
- Article first published online: 4 OCT 2012
- Manuscript Accepted: 14 SEP 2012
- Manuscript Revised: 13 SEP 2012
- Manuscript Revised: 1 AUG 2012
- Manuscript Received: 13 JUL 2012
- Italina Ministry of Health. Grant Number: I85J07000080001
A variety of tests have been proposed for colorectal cancer (CRC), giving rise to uncertainty regarding the optimal approach. The efficacy and effectiveness of different tests are related to both screenee participation and the detection rate.
To perform a meta-analysis on adherence and detection rates of CRC screening tests.
Relevant publications were identified by MEDLINE/EMBASE and other databases for the period 1999–2012. A previous systematic review was used for the period before 1966–1999. RCTs and controlled studies including a direct comparison of the uptake rates among different options for CRC screening were included. Adherence and detection rates for advanced neoplasia and cancer were extracted. Risk for bias was ascertained according to CONSORT guidelines. Forrest plots were produced based on random-effect models.
Fourteen studies provided data on 197 910 subjects. Endoscopic strategies were associated with a lower participation (RR: 0.67, 95% CI: 0.56, 0.80) rate, but a higher detection rate of advanced neoplasia (RR: 3.21, 95% CI: 2.38, 4.32) compared with faecal tests. FIT was superior to g-FOBT with regard to both adherence (RR: 1.16, 95% CI 1.03, 1.30) and detection of advanced neoplasia (RR: 2.28, 95% CI 1.68, 3.10) and cancer (RR: 1.96, 95% CI: 1.2, 3.2).
The superior accuracy of endoscopy compared with faecal tests minimised any impact of the participation rate in determining the detection rate of advanced neoplasia in a screening setting.