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06:46
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Long-term mortality after screening for colorectal cancer
Aasma Shaukat1, Steven J Mongin, Mindy S Geisser
1Division of Gastroenterology, Minneapolis Veterans Affairs Health Care System, Minneapolis, USA.
The New England Journal of Medicine
|September 20, 2013
Summary
Fecal occult-blood testing significantly reduces colorectal cancer deaths for up to 30 years. This screening method does not impact overall mortality but shows a greater benefit for men in biennial screening groups.
Area of Science:
- Gastroenterology
- Oncology
- Preventive Medicine
Background:
- Fecal occult-blood testing (FOBT) is proven to reduce colorectal cancer (CRC) mortality.
- Long-term benefits and sex-specific effects of FOBT screening remain unclear.
Purpose of the Study:
- To evaluate the long-term (30-year) impact of annual and biennial FOBT screening on CRC mortality.
- To assess the influence of FOBT on all-cause mortality and analyze sex-specific differences.
Main Methods:
- A 30-year follow-up of the Minnesota Colon Cancer Control Study involving 46,551 participants aged 50-80.
- Random assignment to annual FOBT, biennial FOBT, or usual care (control group).
- Vital status and cause of death ascertained through the National Death Index through 2008.
Main Results:
- FOBT screening significantly reduced CRC mortality over 30 years (annual RR 0.68, biennial RR 0.78).
- No significant reduction in all-cause mortality was observed with FOBT screening.
- A greater reduction in CRC mortality was noted for men compared to women in the biennial screening arm (P=0.04 for interaction).
Conclusions:
- The mortality benefit of FOBT screening for colorectal cancer persists for at least 30 years.
- FOBT screening does not affect overall mortality rates.
- The sustained CRC mortality reduction supports the efficacy of screening and polypectomy.
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