Colorectal cancer screening with faecal testing, sigmoidoscopy or colonoscopy: a systematic review and network meta-analysis.

摘要: Objective Evaluate effectiveness, harms and burdens of faecal blood testing, sigmoidoscopy colonoscopy screening for colorectal cancer over 15 years. Design We performed an update a Cochrane systematic review, network meta-analysis comparing randomised trials evaluating with guaiac occult test (gFOBT) (annual, biennial), immunochemical (FIT) (once-only) or in healthy population, aged 50–79 conducted subgroup analysis on sex. Follow-up >5 years was required incidence mortality. Results 12 proved eligible. Compared no-screening, we found high certainty evidence slightly reducing (relative risk (RR) 0.76; 95% confidence interval (CI 0.70 to 0.83) mortality (RR 0.74; 95% CI 0.69 0.80), while gFOBT had little no difference incidence, but reduced (annual: RR 0.69; 0.56 0.86, biennial: 0.88; 0.82 0.93). No nor by more than six per 1000 screened Sigmoidoscopy greater effect men, both (women: 0.86; 0.81 0.92, men: 0.75, 0.71 0.79), 0.85; 0.96, 0.67; 0.61 0.75) (moderate certainty). Conclusions In 15-year perspective, reduces sigmoidoscopy, annual biennial all reduce may men women. PROSPERO registration number CRD42018093401.