ArticleEuropean journal of epidemiology2023
When gold standards are not so golden: prevalence bias in randomized trials on endoscopic colorectal cancer screening.
Article in European journal of epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The underestimated preventive effects of flexible sigmoidoscopy screening: re-analysis and meta-analysis of randomized trials.European journal of epidemiology · 2024Pooled it
- The evolving role of OMICS in gastrointestinal tumor biology and clinical practice.Molecular cancer · 2026Review
- Early-detection and prevention effects of screening sigmoidoscopy: evidence from randomized trials revisited.Journal of the National Cancer Institute · 2026Article
- Overcoming prevalence bias in colorectal cancer screening studies by sensible analyses rather than ignoring it or giving up relevant effect measures.European journal of epidemiology · 2025Article
- No "prevalence bias" in randomized controlled trials on colorectal cancer screening: the importance of clarifying the research question.European journal of epidemiology · 2025Article
- Choosing a sensible contrast makes "prevalence bias" irrelevant in screening colonoscopy trials.European journal of epidemiology · 2025Article
- Looking at randomized trials with the critical eyes of epidemiologists: the case of screening colonoscopy.European journal of epidemiology · 2025Article
- Potential for enhancing efficacy of screening colonoscopy by lowering starting ages and extending screening intervals: A modelling study for Germany.International journal of cancer · 2025Article
- Unraveling the effects of screening colonoscopy on colorectal cancer early detection and prevention: the NordICC trial revisited.Cancer communications (London, England) · 2025Article
- The Erosion of Healthcare and Scientific Integrity: A Growing Concern.Journal of healthcare leadership · 2025Review
- Re: Interpreting epidemiologic studies of colorectal cancer prevention.European journal of epidemiology · 2024Article
- Authors' Reply: Interpreting epidemiologic studies of colorectal cancer prevention.European journal of epidemiology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Randomized trials on the effectiveness of screening endoscopy in reducing colorectal cancer (CRC) risk have reported statistically significant, but rather modest reduction of CRC risk by the screening offer. However, risk estimates in these trials included substantial proportions of prevalent CRC cases which were early detected, but could not possibly have been prevented by screening. Thereby, a key principle of randomized prevention trials is violated that only "at risk" persons who do not yet have the disease one aims to prevent should be included in measures of preventive effects. Using recently published data from the Nordic-European Initiative on Colorectal Cancer (NordICC) trial as an example, we illustrate that approaches aimed to account for "prevalence bias" lead to effect estimates that are substantially larger than those reported in the trial and more in line with results from observational studies and real life settings. More rigorous methodological work is needed to develop effective and user-friendly tools to prevent or adjust for prevalence bias in future screening studies.
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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.