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Systematic review with meta‐analysis: the comparative effectiveness of aspirin vs. screening for colorectal cancer prevention

Emilsson, L. ; Holme, Ø. ; Bretthauer, M. ; Cook, N. R. ; Buring, J. E. ; Løberg, M. ; Adami, H.‐O. ; Sesso, H. D. ; Gaziano, M. J. ; Kalager, M.

Alimentary pharmacology & therapeutics, 2017-01, Vol.45 (2), p.193-204 [Periódico revisado por pares]

England: Wiley Subscription Services, Inc

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Título:
Systematic review with meta‐analysis: the comparative effectiveness of aspirin vs. screening for colorectal cancer prevention
Autor: Emilsson, L. ; Holme, Ø. ; Bretthauer, M. ; Cook, N. R. ; Buring, J. E. ; Løberg, M. ; Adami, H.‐O. ; Sesso, H. D. ; Gaziano, M. J. ; Kalager, M.
Assuntos: Aspirin ; Aspirin - therapeutic use ; Cancer och onkologi ; Colon cancer ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - diagnosis ; Colorectal Neoplasms - epidemiology ; Colorectal Neoplasms - prevention & control ; Early Detection of Cancer ; Farmakologi och toxikologi ; Gastroenterologi ; Health risk assessment ; Health risks ; Humans ; Incidence ; Klinisk medicin ; Mass Screening ; Medicin och hälsovetenskap ; Medicinska och farmaceutiska grundvetenskaper ; Meta-analysis ; Mortality ; Randomization ; Randomized Controlled Trials as Topic ; Risk assessment ; Sigmoidoscopy
É parte de: Alimentary pharmacology & therapeutics, 2017-01, Vol.45 (2), p.193-204
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
ObjectType-Review-4
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ObjectType-Undefined-3
Descrição: Summary Background Both aspirin use and screening with flexible sigmoidoscopy or guaiac faecal occult blood testing (FOBT) may reduce mortality from colorectal cancer, but comparative effectiveness of these interventions is unknown. Aim To compare aspirin to guaiac FOBT screening with regard to incidence and mortality of colorectal cancer in a network meta‐analysis. Methods We searched Medline, EMBASE and the COCHRANE central register (CENTRAL) for relevant randomised trials identified until 31 October 2015. Randomised trials in average‐risk populations that reported colorectal cancer mortality, colorectal cancer incidence, or both, with a minimum follow‐up of 2 years, and more than 100 randomised individuals were included. Three investigators independently extracted data. We calculated relative risks [RR with 95% predictive intervals (PrIs)] for the comparison of the interventions by frequentist network meta‐analyses. Results The effect of aspirin on colorectal cancer mortality was similar to FOBT (RR 1.03; 95% PrI 0.76–1.39) and flexible sigmoidoscopy (RR 1.16; 95% PrI 0.84–1.60). Aspirin was more effective than FOBT (RR 0.36; 95% PrI 0.22–0.59) and flexible sigmoidoscopy (RR 0.37; 95% PrI 0.22–0.62) in preventing death from or cancer in the proximal colon. Aspirin was equally effective as screening in reducing colorectal cancer incidence, while flexible sigmoidoscopy was superior to FOBT (RR 0.84; 95% PrI 0.72–0.97). Conclusions Low‐dose aspirin seems to be equally effective as flexible sigmoidoscopy or guaiac FOBT screening to reduce colorectal cancer incidence and mortality, and more effective for cancers in the proximal colon. A randomised comparative effectiveness trial of aspirin vs. screening is warranted.
Editor: England: Wiley Subscription Services, Inc
Idioma: Inglês

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Systematic review with meta‐analysis: the comparative effectiveness of aspirin vs. screening for colorectal cancer prevention

Emilsson, L. ; Holme, Ø. ; Bretthauer, M. ; Cook, N. R. ; Buring, J. E. ; Løberg, M. ; Adami, H.‐O. ; Sesso, H. D. ; Gaziano, M. J. ; Kalager, M.

England: Wiley Subscription Services, Inc

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