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. 2020 Aug 15;11(20):5953-5970.
doi: 10.7150/jca.46661. eCollection 2020.

Colonoscopic screening is associated with reduced Colorectal Cancer incidence and mortality: a systematic review and meta-analysis

Jiaxin Zhang  1   2 , Guang Chen  1   2 , Zhiguo Li  1   2 , Peng Zhang  1   2 , Xiaoke Li  1   2 , Da'nan Gan  1   2 , Xu Cao  1   2 , Hongbo Du  1   2 , Jiaying Zhang  3 , Ludan Zhang  1   2 , Yong'an Ye  1   2
Affiliations

Colonoscopic screening is associated with reduced Colorectal Cancer incidence and mortality: a systematic review and meta-analysis

Jiaxin Zhang et al. J Cancer. .

Abstract

It is the great priority to detect colorectal cancer (CRC) as early as possible, finally to reduce the incidence and mortality of CRC. However, although colonoscopy is recommended in many consensuses, yet no one systematic review is conducted to figure out how colonoscopy could change the incidence and mortality. In our study, we conducted a comprehensive meta-analysis to evaluate the association between colonoscopy screening and the incidence or mortality of CRC. PubMed, EMBASE, and PMC database were systematically searched from their inception to June 2020. A total of 13 cohort and 16 case-control studies comprising 4,713,778 individuals were obtained in this review. Our results showed that colonoscopy was associated with a 52% RR reduction in incidence of CRC (RR: 0.48, 95% CI: 0.46-0.49) and 62% RR reduction in mortality of CRC (RR: 0.38, 95% CI: 0.36-0.40). Subgroup analysis of different interventions, study design, country, sample size, age or sex showed that the incidence and mortality reduction remained consistent, and colonoscopy screening had the same effect on people below and above 50. Our study indicated that colonoscopy could significantly reduce the incidence and mortality of CRC.

Keywords: colonoscopy; colorectal cancer; incidence and mortality; meta-analysis.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
Colonoscopy associated with the incidence reduction of CRC and after excluding one related article; (A) Forest plot; (B) Sensitivity analysis; (C) Forest plot; (D) Sensitivity analysis.
Figure 2
Figure 2
Colonoscopy associated with the incidence reduction of CRC and after excluding one related article; (A) Forest plot; (B) Sensitivity analysis; (C) Forest plot; (D) Sensitivity analysis.
Figure 3
Figure 3
Colonoscopy was associated with a reduced incidence of CRC in a subgroup analysis of forest plots; (A) Intervention; (B) Study design; (C) Country; (D) Sample size; (E) Age; (F) Sex.
Figure 3
Figure 3
Colonoscopy was associated with a reduced incidence of CRC in a subgroup analysis of forest plots; (A) Intervention; (B) Study design; (C) Country; (D) Sample size; (E) Age; (F) Sex.
Figure 3
Figure 3
Colonoscopy was associated with a reduced incidence of CRC in a subgroup analysis of forest plots; (A) Intervention; (B) Study design; (C) Country; (D) Sample size; (E) Age; (F) Sex.
Figure 4
Figure 4
Colonoscopy associated with the mortality reduction of CRC; (A) Forest plot; (B) Sensitivity analysis.
Figure 5
Figure 5
Colonoscopy was associated with a reduced morality of CRC in a subgroup analysis of forest plots; (A) Intervention; (B) Study design; (C) Country; (D) Sample size; (E) Age; (F) Sex.
Figure 5
Figure 5
Colonoscopy was associated with a reduced morality of CRC in a subgroup analysis of forest plots; (A) Intervention; (B) Study design; (C) Country; (D) Sample size; (E) Age; (F) Sex.
Figure 5
Figure 5
Colonoscopy was associated with a reduced morality of CRC in a subgroup analysis of forest plots; (A) Intervention; (B) Study design; (C) Country; (D) Sample size; (E) Age; (F) Sex.
Figure 6
Figure 6
The Begg's funnel plot of the publication bias; (A) incidence; (B) mortality.
See this image and copyright information in PMC

References

    1. Brody H. Colorectal cancer. Nature. 2015;521:S1. - PubMed
    1. Petrelli F, Labianca R, Zaniboni A, Lonardi S, Galli F, Rulli E. et al. Assessment of Duration and Effects of 3 vs 6 Months of Adjuvant Chemotherapy in High-Risk Stage II Colorectal Cancer: A Subgroup Analysis of the TOSCA Randomized Clinical Trial. JAMA oncology. 2020;6(4):547–551. - PMC - PubMed
    1. Weitz J, Koch M, Debus J, Hohler T, Galle PR, Buchler MW. Colorectal cancer. Lancet (London, England) 2005;365:153–65. - PubMed
    1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA: a cancer journal for clinicians. 2009;59:225–49. - PubMed
    1. Expert Consensus on early Colorectal cancer screening Process in China (2019, Shanghai)Chinese Journal of Digestive endoscopy. 2019;10: 709-19. (in Chinese)