Potential biases in colorectal cancer screening using faecal occult blood test

Dea Grip Riboe; Tilde Steen Dogan; John Brodersen

doi:10.1111/j.1365-2753.2012.01824.x

Potential biases in colorectal cancer screening using faecal occult blood test

Dea Grip Riboe, Tilde Steen Dogan, John Brodersen

5 Citationer (Scopus)

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.

Originalsprog	Engelsk
Tidsskrift	Journal of Evaluation in Clinical Practice Online
Vol/bind	19
Udgave nummer	2
Sider (fra-til)	311-6
Antal sider	6
ISSN	1365-2753
DOI	https://doi.org/10.1111/j.1365-2753.2012.01824.x
Status	Udgivet - apr. 2013

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10.1111/j.1365-2753.2012.01824.x

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@article{cd4005fc26584db79a5e394f1e5618ea,

title = "Potential biases in colorectal cancer screening using faecal occult blood test",

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.",

keywords = "Bias (Epidemiology), Colorectal Neoplasms, Databases, Factual, Denmark, Early Detection of Cancer, Humans, Mass Spectrometry, Occult Blood, Randomized Controlled Trials as Topic, Research Design",

author = "Riboe, {Dea Grip} and Dogan, {Tilde Steen} and John Brodersen",

note = "{\textcopyright} 2012 Blackwell Publishing Ltd.",

year = "2013",

month = apr,

doi = "10.1111/j.1365-2753.2012.01824.x",

language = "English",

volume = "19",

pages = "311--6",

journal = "Journal of Evaluation in Clinical Practice Online",

issn = "1365-2753",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "2",

}

TY - JOUR

T1 - Potential biases in colorectal cancer screening using faecal occult blood test

AU - Riboe, Dea Grip

AU - Dogan, Tilde Steen

AU - Brodersen, John

PY - 2013/4

Y1 - 2013/4

N2 - 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.

AB - 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.

KW - Bias (Epidemiology)

KW - Colorectal Neoplasms

KW - Databases, Factual

KW - Denmark

KW - Early Detection of Cancer

KW - Humans

KW - Mass Spectrometry

KW - Occult Blood

KW - Randomized Controlled Trials as Topic

KW - Research Design

U2 - 10.1111/j.1365-2753.2012.01824.x

DO - 10.1111/j.1365-2753.2012.01824.x

M3 - Journal article

C2 - 22332801

SN - 1365-2753

VL - 19

SP - 311

EP - 316

JO - Journal of Evaluation in Clinical Practice Online

JF - Journal of Evaluation in Clinical Practice Online

IS - 2

ER -

Potential biases in colorectal cancer screening using faecal occult blood test

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