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Estimated Lifetime Gained With Cancer Screening Tests: A Meta-Analysis of Randomized Clinical Trials.
Michael Bretthauer1, Paulina Wieszczy1,2, Magnus Løberg1
1Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Department for Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
JAMA Internal Medicine
|August 28, 2023
Summary
Common cancer screening tests, except possibly sigmoidoscopy for colorectal cancer, do not significantly extend lifetime. This meta-analysis found limited evidence that screening significantly increases longevity.
Area of Science:
- Oncology
- Preventive Medicine
- Biostatistics
Background:
- Cancer screening tests are widely promoted for their potential to increase longevity.
- However, robust evidence quantifying the actual lifetime gained from commonly used cancer screening methods is lacking.
Approach:
- A systematic review and meta-analysis of randomized clinical trials (RCTs) with over 9 years of follow-up was conducted.
- Included were 6 common cancer screening tests: mammography, colonoscopy, sigmoidoscopy, fecal occult blood testing (FOBT), computed tomography (CT) for lung cancer, and prostate-specific antigen (PSA) testing.
- Data from 2,111,958 participants were analyzed to estimate absolute lifetime gained.
Key Points:
- Only sigmoidoscopy demonstrated a statistically significant increase in lifetime gained (110 days).
- Mammography, FOBT, PSA testing, and CT lung cancer screening showed no significant lifetime gain.
- Colonoscopy yielded a non-significant gain of 37 days.
Conclusions:
- Current evidence does not strongly support the claim that most common cancer screening tests significantly extend lifespan.
- Sigmoidoscopy for colorectal cancer screening may offer a modest benefit in longevity.
- Further research may be needed to clarify the long-term impact of various cancer screening modalities.
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