Journal Reading

Long-Term Mortality after Screening for Colorectal Cancer

Aasma S, Steven J M, Mindy S G, Frank A L, John H B, Jack S M,et al N Engl J Med 2013;369:1106-14. Colorectal cancer, also known as colon cancer, rectal cancer, or bowel cancer, is a cancer from uncontrolled cell growth in the colon or rectum (parts of the large intestine), or in the appendix. Most colorectal cancer occurs due to lifestyle and increasing age. A fecal occult blood test is done primarily to detect or prevent colon cancer in people without intestinal symptoms. This study was doing in The Minnesota Colon Cancer Control Study with randomly assigned 46,551 healthy volunteers, 50 to 80 years of age, to annual screening, biennial screening, or usual care (control). Recruitment and randomization occurred from 1975 through 1978. Screening took place from 1976 through 1992. A total of 15,873 deaths were reported previously and an additional 17,147 occurred during 30 years of follow-up, for a total of 33,020 deaths. There were 732 deaths from colorectal cancer: 200 deaths from colorectal cancer out of 11,072 total deaths (1.8%) in the annual-screening group, 237 of 11,004 (2.2%) in the biennial-screening group, and 295 of 10,944 (2.7%) in the control group. Annual and biennial screening with fecal occult-blood testing reduced colorectal-cancer mortality; the relative risk of death from colorectal cancer was 0.68 (95% confidence interval [CI], 0.56 to 0.82) with annual screening and 0.78 (95% CI, 0.65 to 0.93) with biennial screening. There is a sustained reduction in long-term mortality with colorectalcancer screening, with no observable reduction in allcause mortality or in mortality not related to colorectal cancer. The reduction in colorectalcancer mortality may be greater among men than among women.

Will be presented by Herianto On Saturday, March 29th 2014