Evidence map›Paper›PMID 38830030›Full record

ArticleJNCI cancer spectrum2024

Colorectal cancer screening with fecal immunochemical testing or primary colonoscopy: inequities in diagnostic yield.

Carl Bonander, Marcus Westerberg, Gabriella Chauca Strand, Anna Forsberg, Ulf Strömberg

Registry-linked trialAbstract read
In one paragraph

Article in JNCI cancer spectrum, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02078804 (SCREESCO - Screening of Swedish Colons), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT02078804 naactive not recruitingnot on this map

SCREESCO - Screening of Swedish Colons

TypeinterventionalSponsorUppsala University HospitalRan2014 to 2030Enrolled278,000ConditionsColorectal CancerArmsColonoscopy
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Carl BonanderSchool of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.ORCID 0000-0002-1189-9950
Marcus WesterbergDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.ORCID 0000-0002-8906-6967
Gabriella Chauca StrandSchool of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.ORCID 0000-0002-0940-9166
Anna ForsbergDepartment of Medicine K2, Karolinska Institutet, Solna, Sweden.ORCID 0000-0002-7048-3357
Ulf StrömbergSchool of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.ORCID 0000-0002-6373-1973

Funding

Swedish Research Council for Health, Working Life and Welfare 2023-01104
6 · The paper itself

Abstract

backgroundSocioeconomic inequalities in the uptake of colorectal cancer screening are well documented, but the implications on inequities in health gain remain unclear.

methodsSixty-year-olds were randomly recruited from the Swedish population between March 2014 and March 2020 and invited to undergo either 2 rounds of fecal immunochemical testing (FIT) 2 years apart (n = 60 137) or primary colonoscopy just once (n = 30 400). By linkage to Statistics Sweden's registries, we obtained socioeconomic data. In each defined socioeconomic group, we estimated the cumulative yield of advanced neoplasia in each screening arm (intention-to-screen analysis). In the biennial FIT arm, we predicted the probability of exceeding the yield in the primary colonoscopy arm by linear extrapolation of the cumulative yield to (hypothetical) additional rounds of FIT.

resultsIn the lowest income group, the yield of advanced neoplasia was 1.63% (95% confidence interval [CI] = 1.35% to 1.93%) after 2 rounds of FIT vs 1.93% (95% CI = 1.49% to 2.40%) in the primary colonoscopy arm. Extrapolation to a third round of FIT implied a 86% probability of exceeding the yield in the primary colonoscopy arm. In the highest income group, we found a more pronounced yield gap between the 2 screening strategies-2.32% (95% CI = 2.15% to 2.49%) vs 3.71% (95% CI = 3.41% to 4.02%)- implying a low (2%) predicted probability of exceeding yield after a third round of FIT.

conclusionsYield of advanced neoplasia from 2 rounds of FIT 2 years apart was poorer as compared with primary colonoscopy, but the difference was less in lower socioeconomic groups. CLINICAL

trial registrationClinicalTrials.gov identifier NCT02078804.

Indexed as

ColonoscopyColorectal NeoplasmsEarly Detection of CancerOccult BloodAgedFecesFemaleHealthcare DisparitiesHumansImmunochemistryIncomeMaleMiddle AgedSocioeconomic FactorsSweden

Identifiers

PMID38830030
PMCPMC11187582

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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.