Evidence map›Paper›PMID 29710125›Full record

Trial reportAnnals of internal medicine2018

Long-Term Effectiveness of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality in Women and Men: A Randomized Trial.

Øyvind Holme, Magnus Løberg, Mette Kalager, Michael Bretthauer, Miguel A Hernán, Eline Aas, Tor J Eide, Eva Skovlund, Jon Lekven, Jörn Schneede and 5 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00119912 (Norwegian Colorectal Cancer Prevention Trial), which is not on this map. Cited by 78 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 9 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00119912 naactive not recruitingnot on this map

Norwegian Colorectal Cancer Prevention Trial

TypeinterventionalSponsorNorwegian Institute of Public HealthRan1999 to 2036Enrolled100,000ConditionsColorectal Cancer, AdenomaArmsA 1 Intervention arm Flex Sig, A 2 Intervention arm Flex Sig + iFOBT
3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 9 syntheses or guidelines pooled it, 157 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Modeling in Colorectal Cancer Screening: Assessing External and Predictive Validity of MISCAN-Colon Microsimulation Model Using NORCCAP Trial Results.Medical decision making : an international journal of the Society for Medical Decision Making · 2018
    Trial
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review

18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 8 institutions in 3 countries.

Øyvind HolmeSørlandet Hospital Kristiansand, Kristiansand, Norway, and University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway (Ø.H., M.L., M.B., T.J.E.).
Magnus LøbergSørlandet Hospital Kristiansand, Kristiansand, Norway, and University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway (Ø.H., M.L., M.B., T.J.E.).
Mette KalagerUniversity of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway, and Harvard T.H. Chan School of Public Health and Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts (M.K., M.A.H.).
Michael BretthauerSørlandet Hospital Kristiansand, Kristiansand, Norway, and University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway (Ø.H., M.L., M.B., T.J.E.).
Miguel A HernánUniversity of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway, and Harvard T.H. Chan School of Public Health and Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts (M.K., M.A.H.).
Eline AasHarvard T.H. Chan School of Public Health and Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts; University of Oslo Institute of Health and Society, Oslo, Norway (E.A.).
Tor J EideSørlandet Hospital Kristiansand, Kristiansand, Norway, and University of Oslo Institute of Health and Society and Oslo University Hospital, Oslo, Norway (Ø.H., M.L., M.B., T.J.E.).
Eva SkovlundOslo University Hospital, Oslo, Norway; orwegian University of Science and Technology, Trondheim, Norway (E.S.).
Jon LekvenUniversity of Bergen Surgical Research Laboratory, Bergen, Norway (J.L.).
Jörn SchneedeUmeå University Clinical Pharmacology Unit, Umeå, Sweden (J.S.).
Kjell Magne TveitOslo University Hospital and University of Oslo Institute of Clinical Medicine, Oslo, Norway (K.M.T., M.V.).
Morten VatnOslo University Hospital and University of Oslo Institute of Clinical Medicine, Oslo, Norway (K.M.T., M.V.).
Giske UrsinUniversity of Oslo Institute of Clinical Medicine, Oslo, Norway; Cancer Registry of Norway and University of Oslo Institute of Basic Medical Sciences, Oslo, Norway, and University of Southern California Keck School of Medicine, Los Angeles, California (G.U.).
Geir HoffUniversity of Oslo Institute of Clinical Medicine and Cancer Registry of Norway, Oslo, Norway, and Telemark Hospital, Skien, Norway (G.H.).
NORCCAP Study Group†
Oslo University Hospital · NOUniversity of Oslo · NOHarvard–MIT Division of Health Sciences and Technology · USSørlandet Sykehus · NOTelemark Hospital · NOUmeå University · SEUniversity of Bergen · NOUniversity of Southern California · US

Funding

Statistical Methods for the Spatio-Temporal Assessment of Social Disparities in CancerP01CA134294 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI HANEUSE, SEBASTIEN, HERNAN, MIGUEL · 2008 to 2017
$6.8M
NCI NIH HHS P01 CA134294
6 · The paper itself

Abstract

Background: The long-term effects of sigmoidoscopy screening on colorectal cancer (CRC) incidence and mortality in women and men are unclear. Objective: To determine the effectiveness of flexible sigmoidoscopy screening after 15 years of follow-up in women and men. Design: Randomized controlled trial. (ClinicalTrials.gov: NCT00119912). Setting: Oslo and Telemark County, Norway. Participants: Adults aged 50 to 64 years at baseline without prior CRC. Intervention: Screening (between 1999 and 2001) with flexible sigmoidoscopy with and without additional fecal blood testing versus no screening. Participants with positive screening results were offered colonoscopy. Measurements: Age-adjusted CRC incidence and mortality stratified by sex. Results: Of 98 678 persons, 20 552 were randomly assigned to screening and 78 126 to no screening. Adherence rates were 64.7% in women and 61.4% in men. Median follow-up was 14.8 years. The absolute risks for CRC in women were 1.86% in the screening group and 2.05% in the control group (risk difference, -0.19 percentage point [95% CI, -0.49 to 0.11 percentage point]; HR, 0.92 [CI, 0.79 to 1.07]). In men, the corresponding risks were 1.72% and 2.50%, respectively (risk difference, -0.78 percentage point [CI, -1.08 to -0.48 percentage points]; hazard ratio [HR], 0.66 [CI, 0.57 to 0.78]) (P for heterogeneity = 0.004). The absolute risks for death from CRC in women were 0.60% in the screening group and 0.59% in the control group (risk difference, 0.01 percentage point [CI, -0.16 to 0.18 percentage point]; HR, 1.01 [CI, 0.77 to 1.33]). The corresponding risks for death from CRC in men were 0.49% and 0.81%, respectively (risk difference, -0.33 percentage point [CI, -0.49 to -0.16 percentage point]; HR, 0.63 [CI, 0.47 to 0.83]) (P for heterogeneity = 0.014). Limitation: Follow-up through national registries. Conclusion: Offering sigmoidoscopy screening in Norway reduced CRC incidence and mortality in men but had little or no effect in women. Primary Funding Source: Norwegian government and Norwegian Cancer Society.

Indexed as

SigmoidoscopyCause of DeathColorectal NeoplasmsEarly Detection of CancerFemaleFollow-Up StudiesHumansIncidenceMaleMass ScreeningNorwayOccult BloodProportional Hazards ModelsRegistriesRisk Reduction BehaviorSex Factors

Identifiers

PMID29710125
PMCPMC6853067
OpenAlexW2799813338

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.