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 colorectal-
cancer 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