"Clinical Effectiveness of Colonoscopy Screening in Reducing Colorectal Cancer Risk".The New England Journal of Medicine. 2022.ClinicalTrials.gov number, NCT00883792.
Links to original sources: Wiki Journal Post Full Journal Article
Does an invitation to undergo a single screening colonoscopy reduce the risk of colorectal cancer and related death in a healthy population aged 55 to 64?
Invitation to undergo a single screening colonoscopy in a population-based randomized trial was associated with an 18% reduced risk of colorectal cancer over 10 years compared to no screening intervention, although participation was 42%.
Colorectal cancer is the third most common type of cancer and a leading cause of cancer death worldwide. While several colorectal cancer screening methods exist, high-quality evidence for the best strategies is limited. The Nordic-European Initiative on Colorectal Cancer (NordICC) trial aimed to evaluate the effects of colonoscopy screening on colorectal cancer risk and related mortality after 10 years. Participation among those invited for colonoscopy was 42%, and an 18% risk reduction in colorectal cancer was observed in the invitation group, with no significant difference in mortality from colorectal cancer or overall mortality after 10 years.
There are currently no updated guidelines incorporating the results of this trial.
Multicenter, pragmatic, randomized controlled trial with participants randomized in a 1:2 ratio to receive an invitation to a single screening colonoscopy (invited group) or no invitation (usual-care group).
84,585 participants aged 55 to 64, drawn from population registries in Poland, Norway, and Sweden.
42% of the invited group underwent screening colonoscopy.
Primary outcomes: - Risk of colorectal cancer after 10 years was 0.98% in the invited group vs. 1.20% in the usual-care group (risk reduction of 18%, risk ratio 0.82; 95% CI, 0.70 to 0.93). - Risk of death from colorectal cancer was 0.28% in the invited group vs. 0.31% in the usual-care group (risk ratio 0.90; 95% CI, 0.64 to 1.16).
Secondary outcome: - Risk of death from any cause was similar in both groups (11.03% invited vs. 11.04% usual-care; risk ratio 0.99; 95% CI, 0.96 to 1.04).
- Lower than expected participation rate in colonoscopy screening. - The study did not capture the effect of adherence to follow-up recommendations for polyp surveillance. - Additional analyses are required for assessments related to distal vs. proximal cancers, sex, and age-related differences.
Research grants from the Research Council of Norway and others, bowel preparation from Dr. Falk Pharma, grants from National Center for Research and Development of Poland, and other national grant agencies.
Additional results and analyses of this trial are reported in the New England Journal of Medicine, 2022.